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MARY JANETTE SULLIVAN CRNP
NPI 1356620009
Nurse Practitioner - Family in Birmingham, AL

Active since August 12, 2011PECOS Enrolled
2100 SOUTHBRIDGE PKWY STE 650, BIRMINGHAM, AL 35209(205) 533-8902(855) 737-5542 Get Directions Write a Review

NPPES record last updated: April 8, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 8, 2019, Aug 25, 2017, Aug 8, 2017 (3 updates tracked since 2017).

About Mary Janette Sullivan Crnp NPPES

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

MARY JANETTE SULLIVAN CRNP (NPI 1356620009) is an individual family provider in Birmingham, Alabama, licensed in Alabama (1-077197) and active in the NPI registry since August 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356620009
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARY JANETTE SULLIVANCredential: CRNP
Location Address2100 SOUTHBRIDGE PKWY STE 650Birmingham, AL 35209-1302
Mailing Address333 Commerce St Ste 700Nashville, TN 37201-1835 · (615) 454-9850
Phone(205) 533-8902
Fax(855) 737-5542
Sole ProprietorNo
Enumeration DateAugust 12, 2011
Last NPPES UpdateApril 8, 20193 updates tracked since enumeration
✔ NPI 1356620009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AL · 1-077197
2100 SOUTHBRIDGE PKWY STE 650, Birmingham, AL 35209
Open in Google Maps ↗

Other Names 1

Professional Name (2)Mary Janette Wilmoth

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Janette Sullivan Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Mary Sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Centers For Developmentally Disabled, North Central Al
77 mi
Family
1602 CHURCH ST SE
Decatur, AL 35601
  • Reassigned Medicare billing, Alabama enrollment
  • 3 clinicians in this Medicare group
NPI 1740493436 (256) 350-1458

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35209 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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 20

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

WAYNETTE K SMITH LPC-S
Counselor (Professional)
2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM, AL 35209
Jefferson County (205) 572-0562
SUNKEISSA CANTRELL LPC
Counselor (Professional)
2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM, AL 35209
Jefferson County (205) 961-4328
NATHANIEL BAIN
Social Worker (Clinical)
2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM, AL 35209
Jefferson County (662) 554-8071
LEXACARE LLC
Specialist/Technologist, Other (Surgical Assistant)
2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM, AL 35209
Jefferson County (205) 414-7002
TAMIKA LASHONE CARTER-ALEXANDER
Social Worker
2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM, AL 35209
Jefferson County (205) 382-1627
HEATHER BRYAN DAVIS CRNP
Nurse Practitioner
2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM, AL 35209
Jefferson County (205) 533-8902
HAL MEDICAL O&P
Durable Medical Equipment & Medical Supplies
2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM, AL 35209
Jefferson County (256) 230-2321
ASHETON MARIE TANAHEY
Counselor (Mental Health)
2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM, AL 35209
Jefferson County (646) 941-7645

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 Mary Sullivan's NPI number?

The NPI number for Mary Sullivan is 1356620009. It was assigned to this individual provider in the NPPES registry on August 12, 2011. The provider is also known as Mary Janette Wilmoth.

Where is Mary Sullivan located?

Mary Sullivan practices at 2100 Southbridge Pkwy Ste 650, Birmingham, AL 35209. The listed phone number is (205) 533-8902.

What is Mary Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mary Sullivan enrolled in Medicare?

Yes. Mary Sullivan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Sullivan reassigns Medicare benefits to Centers For Developmentally Disabled, North Central Al (Decatur, AL). The 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 Mary Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Sullivan was last updated on April 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.