MRS. LACEY SULLIVAN (FNP-BC) – Nurse Practitioner, NPI 1174951503
Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for MRS. LACEY SULLIVAN (FNP-BC)
608 MAPLE VALLEY DR
FARMINGTON, MO 636401976
Phone: (573) 756-3400
Fax: (573) 756-0800
Type: Mailing
PO BOX 957683
SAINT LOUIS, MO 631957683
Phone: (573) 358-4600
Fax: (573) 358-4654
Type: Mailing
7245 RAIDER RD STE C
BONNE TERRE, MO 636283767
Phone: (573) 358-4600
Fax: (573) 358-4654
Type: Location
618 MAPLE VALLEY DR
FARMINGTON, MO 63640
Phone: (573) 756-3400
Fax: (573) 756-0800
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 59 Open Payments records for all available years, with a total value of $1,046.
Total Amount is formed as General ($1,046) + Research ($0) + Ownership ($0) = $1,046.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($587).
Total Amount
$1,046
General + Research + Ownership
Payments
59
Total payment records
General Amount
$1,046
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $587 |
| Valinor Pharma, LLC | $190 |
| Exact Sciences Corporation | $89 |
| PFIZER INC. | $72 |
| Novo Nordisk Inc | $52 |
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: 2014-01-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140113001307 | I | Nurse Practitioner | MO | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 43 | 37 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 33 | 33 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 27 | 27 | $0 |
Insurance plans in this area (ZIP 63640)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Certified Nurse Midwife (Cnm), Nurse Practitioner | MO | |
| Physical Medicine And Rehabilitation, Pain Management | MO | |
| Internal Medicine | MO | |
| - | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO |
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