Mallory Breanna Sullivan

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN289418 Issued in GA

Practice address

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3050

Phone

(404) 616-1000

NPI assigned

Nov 12, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grady Memorial Hospital CorporationGroup PAC ID 7517032998, 365 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

Merit-based Incentive Payment System (MIPS)

Final score

96.48 of 100Reported as group

Quality

87.56

Promoting interoperability

100

Improvement activities

40

Cost

75.14

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grady Memorial Hospital Corporation

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1114243813
  Medicare reassignment Care Compare group NPD
• Grady Memorial Hospital Corporation

  • Rehabilitation Hospital
  • Atlanta, GA
  • NPI 1336961119
  NPD
• Grady Memorial Hospital Corporation

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grady Memorial Hospital Corporation

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  Care Compare affiliation

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1124663331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E WEST CONNECTOR APT 121",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068189",
            "telephone_number": "404-844-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033050",
            "telephone_number": "404-616-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MALLORY",
        "middle_name": "BREANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN289418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold Clifford Sullivan III
• Jermaine Nicholas Sullivan, NCC
• Karly Christine Sullivan
• Kenita A. Sullivan
• Kimberly Paige Sullivan, LCSW
• Martin Anthony Sullivan, DC
• Mary Helen Sullivan, MSN, FNP-C
• Natalie Sullivan, MD
• Nechemyah Donte'-Devon Sullivan, LPC, NCC, ECMHC, CPS
• Patrick Sean Sullivan, DVM

• Acute Care Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.