Active NPI
Stephanie Tiv Sullivan, PA-C
- Physician Assistant
- Cumming, GA
National Provider Identifier
1194160044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1230 Bald Ridge Marina Rd Ste 300
Cumming, GA 30041-7859 - Phone
- (770) 814-8222
- Fax
- (678) 205-5111
- NPI assigned
- May 6, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1230 Bald Ridge Marina Rd Ste 300
Cumming, GA 30041-7859
Mailing address
PO Box 23329
New York, NY 10087-3329
Other practice location 1
3020 Highway 124
Snellville, GA 30039-4614
Phone (770) 978-1331
Other practice location 2
3370 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (770) 814-8222
Other practice location 3
1519 Johnson Ferry Rd Ste 175
Marietta, GA 30062-6411
Phone (770) 814-8222
Other practice location 4
3331 Hamilton Mill Rd Ste 1106
Buford, GA 30519-7226
Phone (770) 814-8222
Other practice location 5
3850 Pleasant Hill Rd
Duluth, GA 30096-4807
Phone (770) 814-8222
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1230 Bald Ridge Marina Rd
Suite 300
Cumming, GA 30041-7859
Phone (770) 814-8222
3331 Hamilton Mill Rd
Suite 1106
Buford, GA 30519-7226
Phone (770) 814-8222
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6835 | GA | MD | Dentist |
Interoperability endpoints
- ssullivan@aadermaffiliates.emadirect.md
Organizations & group practices 1
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.
-
- Dermatology Physician
- Duluth, GA
- NPI 1427040799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774915200000",
"number": "1194160044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23329",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100873329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 BALD RIDGE MARINA RD STE 300",
"city": "CUMMING",
"state": "GA",
"postal_code": "300417859",
"telephone_number": "770-814-8222",
"fax_number": "678-205-5111"
}
],
"practiceLocations": [
{
"address_1": "3020 Highway 124",
"address_purpose": "LOCATION",
"city": "Snellville",
"state": "GA",
"postal_code": "300394614",
"country_code": "US",
"telephone_number": "770-978-1331",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3370 Paddocks Pkwy",
"address_purpose": "LOCATION",
"city": "Suwanee",
"state": "GA",
"postal_code": "300249119",
"country_code": "US",
"telephone_number": "770-814-8222",
"fax_number": "678-205-5111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1519 Johnson Ferry Rd Ste 175",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "GA",
"postal_code": "300626411",
"country_code": "US",
"telephone_number": "770-814-8222",
"fax_number": "678-205-5111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3331 Hamilton Mill Rd Ste 1106",
"address_purpose": "LOCATION",
"city": "Buford",
"state": "GA",
"postal_code": "305197226",
"country_code": "US",
"telephone_number": "770-814-8222",
"fax_number": "678-205-5111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3850 Pleasant Hill Rd",
"address_purpose": "LOCATION",
"city": "Duluth",
"state": "GA",
"postal_code": "300964807",
"country_code": "US",
"telephone_number": "770-814-8222",
"fax_number": "678-205-5111",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "STEPHANIE",
"middle_name": "TIV",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-06",
"last_updated": "2026-03-31",
"certification_date": "2026-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.