Cara Noelle Sullivan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MRM-1327 Issued in ID

Practice address

207 1St St S
Nampa, ID 83651-3703

Phone

(208) 466-7869

Fax

(208) 466-5359

NPI assigned

Jun 28, 2013

Last updated

May 1, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of South Florida College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Clinics IncGroup PAC ID 4082527353, 75 clinicians

Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: csullivan1563102@direct.trinity-health.org
• Direct secure messaging: csullivan337685@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Nampa, ID
  • NPI 1457309122

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716
  Medicare reassignment Care Compare group NPD
• Sound Physicians of Idaho

  dba Sound Physicians

  • Hospitalist Physician
  • Lewiston, ID
  • NPI 1730407461
  Medicare reassignment
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Nampa, ID
  • NPI 1134527708

  Family Medicine

  NPD
• Community Health Clinics, Inc.

  dba Terry Reilly - Vista

  • Federally Qualified Health Center (FQHC)
  • Boise, ID
  • NPI 1346254026
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1861676298
  NPD
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Meridian, ID
  • NPI 1215941083

  Family Medicine

  NPD (past)
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Boise, ID
  • NPI 1588678361

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Alphonsus Medical Center Nampa, Inc.

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1659371870
  Care Compare affiliation
• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1912347303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-461-7149",
            "fax_number": "208-467-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 1ST ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513703",
            "telephone_number": "208-466-7869",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CARA",
        "middle_name": "NOELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9694122-1205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRM-1327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith L. Stucki, DMD
• Laurie C Stucki, AU.D.
• Trent Larry Stucki, DMD
• Sudha Subramanyam, MD
• Amanda M Sullivan
• Kermit C Sullivan III, ATC
• Leann Sullivan
• Sabrina Sultana
• Stacy I Summa, PA C
• Summit Psychiatry and Family Wellness

• Family Medicine Physician in Nampa, ID
• Providers in Nampa, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.