COURTNEY SULLIVAN FNP-C NPI 1366852345

NPI Information

  • NPI: 1366852345
  • Provider Name: COURTNEY SULLIVAN, FNP-C
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 505 WOODLAND DRIVE
    KERSHAW, SC
    ZIP 29067
  • Phone: (803) 282-7465

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NPI Details

Courtney Sullivan, FNP-C is a family nurse practitioner in Kershaw, SC with 8 years of experience. Courtney Sullivan, FNP-C NPI is 1366852345. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

505 WOODLAND DRIVE
KERSHAW, SC
ZIP 29067-704
Phone: (803) 282-7465
Fax: (803) 262-0198

The NPI 1366852345 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Extended office or other outpatient service, first hour (HCPCS:99354)
  • Established patient home visit, typically 1 hour (HCPCS:99350)
  • New patient home visit, typically 75 minutes (HCPCS:99345)

The enumeration date for this NPI number is 4/30/2014 and was last updated on 3/30/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily22264SOUTH CAROLINAYes
2163W00000XRegistered Nurse100813SOUTH CAROLINANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11366852345MEDICAIDSOUTH CAROLINA
21366852345OTHERSOUTH CAROLINAALL INSURERS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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