DEVIN SULLIVAN (DNP) – Nurse Practitioner, NPI 1730966102

DEVIN SULLIVAN (DNP) is a healthcare provider. based in Watervliet, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP. They hold a License No. 4704316057 (MI). The NPI Number for DEVIN SULLIVAN (DNP) is 1730966102

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
DEVIN SULLIVAN (DNP)
NPI
1730966102
Phone
(269) 463-3600
Address
400 Medical Park Dr Ste 200
Enumeration Date
11 September 2023
Last Update Date
1 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9549395000
Graduation Year
2023 (3 years ago)
PAC ID
4082065917
Group Practice PAC ID
2769719236
Professional Enrollment ID
I20240104003794
Address ID
MI490852112SA1234XAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:2State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

Provider Addresses for DEVIN SULLIVAN (DNP)

  • 400 Medical Park Dr Ste 200

    Watervliet, MI 490989225

    Phone: (269) 463-3600

    Type: Location

  • 2002 S 11th St

    Niles, MI 491204074

    Phone: (269) 687-0200

    Type: Location

  • 5515 Cleveland Ave

    Stevensville, MI 491279669

    Phone: (269) 429-9677

    Type: Location

  • 9623 Red Arrow Hwy

    Bridgman, MI 491069559

    Phone: (269) 465-6050

    Type: Location

  • 1234 NAPIER AVE

    SAINT JOSEPH, MI 490852112

    Phone: (269) 983-8300

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2024-02-20 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240104003794INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49098)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769719236View full group profile
NameSpecialtyState
Nurse PractitionerMI
Emergency MedicineMI
Nurse PractitionerMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Nurse PractitionerOH
Emergency MedicineMI
-MI
Emergency MedicineOH

Reviews

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Frequently asked questions

Is DEVIN SULLIVAN (DNP) listed with a National Provider Identifier?
Yes — DEVIN SULLIVAN (DNP) has NPI 1730966102 on file in the registry.
Is DEVIN SULLIVAN (DNP) shown as active in public data?
Registry records indicate DEVIN SULLIVAN (DNP) maintains an active NPI.
What clinical focus is listed for DEVIN SULLIVAN (DNP)?
At a glance, DEVIN SULLIVAN (DNP) is tied to Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is DEVIN SULLIVAN (DNP) located near Watervliet?
DEVIN SULLIVAN (DNP) currently maps to Watervliet, Michigan in this extract.
Can I trust this NPI listing for DEVIN SULLIVAN (DNP)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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