Thomas Dennis Sullivan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

15512 Issued in GA

Practice address

3795 Mansell Rd
Alpharetta, GA 30022-8247

Phone

(404) 785-8540

Fax

(404) 785-8574

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1104872001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5318 TROWBRIDGE DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303383623",
            "telephone_number": "770-671-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3795 MANSELL RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300228247",
            "telephone_number": "404-785-8540",
            "fax_number": "404-785-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "THOMAS",
        "middle_name": "DENNIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "15512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000971132",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riffat Sumera Subhani, RPH, MBA
• Suburban Medical Associ
• Shannon Sugarman, MD
• Arielle Handy Sullivan-Harris, M.D.
• Richard Henry Sullivan III, PA
• Summerlin Marriage and Family Therapy Clinics, LLC
• Summit Ivy Inclusion LLC
• Summit One Business Group L.L.C
• Summit Pharmacy
• Daniel Ty Sumner

• Pediatrics Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.