Shane Sullaway
NPI 1366738320ActiveIndividual· Technician, Other· Grand Prairie, TX
Technician, Other in Grand Prairie, Texas, with an NPI issued in June 2011.
Overview
| NPI | 1366738320 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jun 28, 2011 |
| Last updated in NPPES | Jun 28, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Technician, Other Primary | 247200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Technician, Other providers in Grand Prairie
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