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

Q: 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.

Q: What is Lacey Sullivan's specialty?

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

Q: 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 10 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.

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: August 02, 2026.

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

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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, is affiliated with Ste Genevieve County Memorial Hospital, 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 Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ste Genevieve County Memorial Hospital

Critical Access Hospitals · Sainte Genevieve, MO

OwnershipGovernment - Hospital District or Authority

CMS Certification Number261330

Location800 Ste Genevieve Drive, PO Box 468Sainte Genevieve, MO 63670 · Ste. Genevieve County

Emergency services Birthing friendly

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.

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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.

What insurance does Lacey Sullivan accept?

Health plans from Anthem Blue Cross and Blue Shield 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.

Is Lacey Sullivan affiliated with any hospitals?

According to CMS data, Lacey Sullivan is affiliated with Ste Genevieve County Memorial Hospital.

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 10 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.