Bethany S. Sullivan, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3007834 Issued in KY

Practice address

4851 Ky Route 321
Prestonsburg, KY 41653-9113

Phone

(606) 886-1173

Fax

(606) 886-2193

NPI assigned

Jan 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hager and Associates PSCGroup PAC ID 9931114766, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

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

• Hager and Associates PSC

  • Rural Health Clinic/Center
  • Pikeville, KY
  • NPI 1629114707

  Family

  Medicare reassignment Care Compare group NPD
• Crossroads Addiction Recovery Effort, LLC

  • Community/Behavioral Health Agency
  • Pikeville, KY
  • NPI 1942667456
  Medicare reassignment NPD
• Frontier Behavioral Health Center PLLC

  • Multi-Specialty Clinic/Center
  • Salyersville, KY
  • NPI 1295287118
  Medicare reassignment NPD
• J & J Diagnostics

  • Family Medicine Physician
  • Pikeville, KY
  • NPI 1417502733
  Medicare reassignment NPD
• Pikeville Medical Center Inc.

  • Multi-Specialty Clinic/Center
  • Pikeville, KY
  • NPI 1528195864
  Medicare reassignment NPD
• Pikeville Medical Center Inc.

  • Clinic/Center
  • Pikeville, KY
  • NPI 1710207865

  Family

  NPD
• Pikeville Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Cheyenne, WY
  • NPI 1891599502
  NPD

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1962740969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 697",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416530697",
            "telephone_number": "606-886-1173",
            "fax_number": "606-886-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 KY ROUTE 321",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416539113",
            "telephone_number": "606-886-1173",
            "fax_number": "606-886-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BETHANY",
        "middle_name": "S.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100229990",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Djuana Stump
• Randi Stump
• Elizabeth Sturgill
• Kaitlin Sturgill, MHA
• Mark Sturgill
• Danita Sullivan
• Lisa Sullivan
• Tiffany Sullivan
• Tiffany Ann Sullivan, BA
• Shaina Summa

• Family Nurse Practitioner in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; 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.