DR. KELLY INGRID SULLIVAN MD
NPI 1043492291
Pediatrics in College Station, TX
NPI Status: Active since November 29, 2007
Contact Information
1602 ROCK PRAIRIE RD
SUITE 340
COLLEGE STATION, TX
ZIP 77845
Phone: (979) 696-4440
Fax: (979) 696-7812
- Individual
- Female
- Pediatrics
- Accepts Insurance
About KELLY SULLIVAN
This page provides the complete NPI Profile along with additional information for Kelly Sullivan, a pediatrician established in College Station, Texas with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1043492291 assigned on November 2007. The practitioner's primary taxonomy code is 208000000X with license number N1166 (TX). The provider is registered as an individual and her NPI record was last updated 16 years ago.
- NPI
- 1043492291
- Provider Name
- DR. KELLY INGRID SULLIVAN MD
- Other Name
- KELLY INGRID MACHEN
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1602 ROCK PRAIRIE RD SUITE 340 COLLEGE STATION, TX 77845
- Location Phone
- (979) 696-4440
- Location Fax
- (979) 696-7812
- Mailing Address
- 1602 ROCK PRAIRIE RD SUITE 340 COLLEGE STATION, TX 77845
- Mailing Phone
- (979) 696-4440
- Mailing Fax
- (979) 696-7812
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-29-2007
- Last Update Date
- 05-21-2010
- Code Navigator
A pediatrician like Kelly Sullivan is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- N1166
- License State
- TX
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BSW Diabetes Care Gold HMO 014 - HMO
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Elite Gold HMO 004 - HMO
- BSW Elite Gold HMO 012 - HMO
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Prime Silver HMO 008 - HMO
- BSW Prime Silver HMO 005 - HMO
- BSW Savers Bronze HMO H S A 006 - HMO
- BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Savers Bronze HMO H S A 009 - HMO
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
- Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
- Moda Select Texas Bronze HDHP 7500 - EPO
- Moda Select Texas Standard Bronze - EPO
- Moda Select Texas Standard Gold - EPO
- Moda Select Texas Standard Silver - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1043492291, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
COLLEGE STATION, TX 77845
COLLEGE STATION, TX 77845
COLLEGE STATION, TX 77845
COLLEGE STATION, TX 77845
COLLEGE STATION, TX 77845
COLLEGE STATION, TX 77845
COLLEGE STATION, TX 77845
COLLEGE STATION, TX 77845
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043492291, enumerated as an "individual" on November 29, 2007.
The provider is located at 1602 ROCK PRAIRIE RD SUITE 340 COLLEGE STATION, TX 77845 and the phone number is (979) 696-4440.
Pediatrics with taxonomy code 208000000X.
The provider might be accepting Accepts: Baylor Scott and White Health Plan and Moda Health. Please consult your insurance carrier or call the provider to verify.
