Kelli Anne-marie Sullivan, in Shawnee, OK - Medicare Nurse Practitioner

Kelli Anne-marie Sullivan, is a medicare enrolled "Nurse Practitioner - Family" in Shawnee, Oklahoma. Her current practice location is 4409 N Kickapoo Ave, Shawnee, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (405) 242-4100.

Kelli Anne-marie Sullivan is licensed to practice in Oklahoma (license number 216574) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1386408656.

Contact Information

	Kelli Anne-marie Sullivan,
	4409 N Kickapoo Ave, Shawnee, OK 74804-1206
	(405) 242-4100
	Not Available

Map and Direction

Provider's Profile

Full Name	Kelli Anne-marie Sullivan
Gender	Female
Speciality	Nurse Practitioner - Family
Location	4409 N Kickapoo Ave, Shawnee, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1386408656
Provider Enumeration Date: 02/07/2024
Last Update Date: 02/07/2024

Medicare PECOS Information:

PECOS PAC ID: 4981049475
Enrollment ID: I20240223001799

Medical Identifiers

Medical identifiers for Kelli Anne-marie Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386408656	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	216574 (Oklahoma)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelli Anne-marie Sullivan allows following entities to bill medicare on her behalf.

Entity Name	Oklahoma Pain Management Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679760912 PECOS PAC ID: 8123117066 Enrollment ID: O20071130000154

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelli Anne-marie Sullivan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kelli Anne-marie Sullivan, 15266 Red Stone Rd, Choctaw, OK 73020-7258 Ph: (405) 313-5261	Kelli Anne-marie Sullivan, 4409 N Kickapoo Ave, Shawnee, OK 74804-1206 Ph: (405) 242-4100

Reviews and Comments

Nurse Practitioner Nurses in Shawnee, OK

Dustin Wade, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2508 N Harrison St, Shawnee, OK 74804 Phone: 405-585-2030
Mrs. Sabrina R Lafrance, CNP-FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 30 Redbud Ln, Shawnee, OK 74801 Phone: 509-554-9250
Jodi Jenista, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 130 N Broadway Ave Ste 300, Shawnee, OK 74801 Phone: 405-395-0399 Fax: 405-395-0330
Susan George, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2029 Gordon Cooper Dr, Shawnee, OK 74801 Phone: 405-878-5850
Cindy Cheatwood, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2508 N Harrison St, Shawnee, OK 74804 Phone: 405-585-2030 Fax: 405-585-2859
Bonnie Nadaene Grude, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5903 Gabriel, Shawnee, OK 74804 Phone: 918-470-0324
Ms. Janet Sue Pasquali Bowers, APRN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3306 N Kickapoo Ave, Suite 150 & 154, Shawnee, OK 74804 Phone: 405-628-6535 Fax: 405-628-6532

Kelli Anne-marie Sullivan, - Medicare Nurse Practitioner in Shawnee, OK