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MRS. LACEY SULLIVAN FNP-BC
NPI 1174951503
Nurse Practitioner in Bonne Terre, MO

Active since October 22, 2013PECOS EnrolledAccepts Medicare Assignment
7245 RAIDER RD STE C, BONNE TERRE, MO 63628(573) 358-4600(573) 358-4654 Get Directions Write a Review

NPPES record last updated: September 17, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 17, 2025, Sep 28, 2022, Feb 12, 2020 (3 updates tracked since 2020).

About Mrs. Lacey Sullivan Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. LACEY SULLIVAN FNP-BC (NPI 1174951503) is an individual nurse practitioner in Bonne Terre, Missouri, licensed in Missouri (2013037701) and active in the NPI registry since October 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1174951503
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. LACEY SULLIVANCredential: FNP-BC
Location Address7245 RAIDER RD STE CBonne Terre, MO 63628-3767
Mailing AddressPo Box 957683Saint Louis, MO 63195-7683 · (573) 358-4600 · Fax (573) 358-4654
Phone(573) 358-4600
Fax(573) 358-4654
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateOctober 22, 2013
Last NPPES UpdateSeptember 17, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2025
✔ NPI 1174951503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MO · 2013037701
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 2013037701 (MO)
7245 RAIDER RD STE C, Bonne Terre, MO 63628
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Other Identifiers 3

Other2013037701MO · Fnp License
Other2013017822MO · Ancc
Other2008021920MO · Rn License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Lacey Sullivan Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395973697
PECOS Enrollment IDI20140113001307
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Lacey Sullivan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mineral Area Pain Center, P.C.
10 mi
Physical Medicine & Rehabilitation
618 MAPLE VALLEY DRIVE
Farmington, MO 63640
  • Reassigned Medicare billing, Missouri enrollment
  • Medicare enrollment name: Mineral Area Pain Center PC
  • 7 clinicians in this Medicare group
NPI 1417973660 (573) 756-3400
Xiaohui's Medical, LLC
10 mi
Pain Medicine
618 MAPLE VALLEY DR
Farmington, MO 63640
  • Reassigned Medicare billing, Missouri enrollment
  • 4 clinicians in this Medicare group
NPI 1518297977 (573) 756-3400
Parkland Health Center
11 mi
General Practice
1101 W LIBERTY ST
Farmington, MO 63640
  • Reassigned Medicare billing, Missouri enrollment
  • 71 clinicians in this Medicare group
NPI 1922016112 (573) 756-6451
Ste Genevieve County Memorial Hospital
27 mi
Rural Health
120 PLAZA DR
Ste Genevieve, MO 63670
  • Reassigned Medicare billing, Missouri enrollment
  • 37 clinicians in this Medicare group
NPI 1154871143 (573) 883-1199

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
136 services62 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
40 services33 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
24 services24 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63628 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

APRIL BRANNUM FNP-C
Nurse Practitioner
7245 RAIDER RD STE C
BONNE TERRE, MO 63628
St. Francois County (573) 358-4600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lacey Sullivan's NPI number?

The NPI number for Lacey Sullivan is 1174951503. It was assigned to this individual provider in the NPPES registry on October 22, 2013.

Where is Lacey Sullivan located?

Lacey Sullivan practices at 7245 Raider Rd Ste C, Bonne Terre, MO 63628. The listed phone number is (573) 358-4600.

What is Lacey Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lacey Sullivan enrolled in Medicare?

Yes. Lacey Sullivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Lacey Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lacey Sullivan reassigns Medicare benefits to 4 organizations: Mineral Area Pain Center, P.C. (Farmington, MO), Xiaohui's Medical, LLC (Farmington, MO), Parkland Health Center (Farmington, MO) and Ste Genevieve County Memorial Hospital (Ste Genevieve, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lacey Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lacey Sullivan accept?

Health plans from UnitedHealthcare list Lacey Sullivan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lacey Sullivan was last updated on September 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.