MRS. KANDIS KAY SULLIVAN
NPI 1861714917
Nurse Practitioner - Primary Care in Tomah, WI

Q: What is Kandis Sullivan's NPI number?

The NPI number for Kandis Sullivan is 1861714917. It was assigned to this individual provider in the NPPES registry on February 17, 2010. The provider is also known as Ms. Kandis Kay Powell R.N..

Q: What is Kandis Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Kandis Sullivan was last updated on July 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since February 17, 2010PECOS Enrolled

500 E VETERANS ST, TOMAH, WI 54660(608) 372-3971 Get Directions Write a Review

NPPES record last updated: July 19, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 3, 2016, Feb 8, 2016 (2 updates tracked since 2016).

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About Mrs. Kandis Kay Sullivan NPPES

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

MRS. KANDIS KAY SULLIVAN (NPI 1861714917) is an individual primary care provider in Tomah, Wisconsin, licensed in Wisconsin (3857-33) and active in the NPI registry since February 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861714917

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameMRS. KANDIS KAY SULLIVAN

Location Address500 E VETERANS STTomah, WI 54660-3105

Mailing Address1904 Cedar Creek DrRothschild, WI 54474-1461 · (715) 470-0502

Phone(608) 372-3971

Sole ProprietorNo

Enumeration DateFebruary 17, 2010

Last NPPES UpdateJuly 19, 20162 updates tracked since enumeration

✔ NPI 1861714917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in WI · 3857-33

Also ListedRegistered NurseTaxonomy 163W00000X · License 108168-030 (WI)

500 E VETERANS ST, Tomah, WI 54660

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Other Names 1

Former Name (1)Ms. Kandis Kay Powell R.n.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Kandis Kay Sullivan 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54660 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

MS. ANNE MARY WALLUS

Dietitian, Registered