Shelby Lynn Sullivan, FNP-C is a medicare enrolled "Nurse Practitioner" physician in Longview, Texas. She graduated from medical school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Christus Trinity Clinic and her current practice location is
707 E Marshall Ave, Longview, Texas. You can reach out to her office (for appointments etc.) via phone at
(903) 315-4880.
Shelby Lynn Sullivan is licensed to practice in Texas (license number 1018780) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1720680267.
Physician's Profile
| Full Name | Shelby Lynn Sullivan |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 707 E Marshall Ave, Longview, Texas |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Shelby Lynn Sullivan graduated from medical school in 2020
NPI Data:
- NPI Number: 1720680267
- Provider Enumeration Date: 11/10/2020
- Last Update Date: 06/09/2022
Medicare PECOS Information:
- PECOS PAC ID: 5395140248
- Enrollment ID: I20210816003427
Medical Identifiers
Medical identifiers for Shelby Lynn Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1720680267 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 1018780 (Texas) | Secondary |
| 363L00000X | Nurse Practitioner | 1018780 (Texas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Christus Trinity Clinic | 3072426741 | 1217 |
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. Shelby Lynn Sullivan allows following entities to bill medicare on her behalf.
| Entity Name | Christus Trinity Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285684225
PECOS PAC ID: 3072426741
Enrollment ID: O20031204001091 |
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| Entity Name | Rheumatology Association Of Longview, Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205026432
PECOS PAC ID: 0345224614
Enrollment ID: O20040615000640 |
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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. Shelby Lynn 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 |
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Shelby Lynn Sullivan, FNP-C
Po Box 846098,
Dallas, TX 75284-6098
Ph: (903) 324-6400 | Shelby Lynn Sullivan, FNP-C
707 E Marshall Ave,
Longview, TX 75601-5545
Ph: (903) 315-4880 |
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