JACQUELINE YVONNE SULLIVAN CNM
NPI 1679847107
Advanced Practice Midwife in Hagerstown, MD
About Jacqueline Yvonne Sullivan Cnm NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE YVONNE SULLIVAN CNM (NPI 1679847107) is an individual advanced practice midwife in Hagerstown, Maryland, licensed in Pennsylvania (MW010272) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS and maintains 6 additional practice locations.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 6
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacqueline Yvonne Sullivan Cnm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Jacqueline Sullivan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Hagerstown, MD 21740
- Reassigned Medicare billing, Pennsylvania enrollment
- 3,080 clinicians in this Medicare group
Fulton, MD 20759
- Reassigned Medicare billing, Maryland enrollment
- Medicare enrollment name: Capital Womens Care LLC
- 167 clinicians in this Medicare group
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 21740 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HAGERSTOWN, MD 21740
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 Jacqueline Sullivan's NPI number?
The NPI number for Jacqueline Sullivan is 1679847107. It was assigned to this individual provider in the NPPES registry on March 1, 2012.
Where is Jacqueline Sullivan located?
Jacqueline Sullivan practices at 1165 Imperial Dr Ste 200, Hagerstown, MD 21740. The listed phone number is (301) 665-9098.
What is Jacqueline Sullivan's specialty?
The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.
Is Jacqueline Sullivan enrolled in Medicare?
Yes. Jacqueline Sullivan is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jacqueline Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Sullivan reassigns Medicare benefits to 2 organizations: Wellspan Medical Group (Hagerstown, MD) and Capital Women's Care, L.L.C. (Fulton, MD). 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 Jacqueline 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 Jacqueline Sullivan was last updated on December 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jacqueline Yvonne Sullivan, CNM · NPI 1679847107
Advanced Practice Midwife physician in Hagerstown, Maryland. Individual provider, active in the CMS NPPES registry since March 1, 2012.
## Identity
- **NPI:** 1679847107 (Entity type: Individual)
- **Enumerated:** March 1, 2012
- **Primary specialty:** Advanced Practice Midwife · taxonomy 367A00000X
- **State license:** MW010272 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 1165 IMPERIAL DR STE 200, Hagerstown, MD 21740-6583
- **Phone:** (301) 665-9098 · **Fax:** (301) 665-9096
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Wellspan Medical Group (NPI 1588249668, Hagerstown, MD); Capital Women's Care, L.L.C. (NPI 1679534069, Fulton, MD) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 1, 2023
- **Other identifiers:** Medicaid 102733511 (PA)
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Source: [NPI Profile](https://npiprofile.com/npi/1679847107) · Data from the CMS NPPES public registry.