Individual provider Active NPI

Bindumole A Sukumar, AGACNP

  • Nurse Practitioner
  • Snellville, GA
National Provider Identifier
1306450390
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN202370 Issued in GA
Practice address
1700 Medical Way
Snellville, GA 30078-2195
Phone
(770) 979-0200
NPI assigned
Sep 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN202370 GA
Nurse Practitioner 363L00000X RN202370 GA Primary

Addresses

Primary practice location

1700 Medical Way
Snellville, GA 30078-2195

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

Clinic #4507
103 Jesse Jewell Pkwy SW
Gainesville, GA 30501
Phone (770) 536-3441

Other practice location 2

4130 Bridle Ridge Dr
Suwanee, GA 30024-6030
Phone (678) 205-7857

Other practice location 3

1404 River Pl Ste 501
Braselton, GA 30517-5600
Phone (770) 534-2020

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220124000319 GA Practitioner - Nurse Practitioner 1557753647 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN202370GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iris Medical Group Nurse Practitioner CurrentSince Mar 1, 2025 Accepting new patients
Vpa PC CurrentSince Jun 1, 2024 Accepting new patients
Piedmont Cardiology of Atlanta, LLC CurrentSince Mar 1, 2025 Accepting new patients
Vpa PC CurrentSince Jun 1, 2024 Accepting new patients
Georgia Heart Institute LLC CurrentSince Aug 1, 2024 Accepting new patients
Iris Wound Care, PC Nurse Practitioner Past Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Nurse Practitioner PastSince Aug 1, 2024 Accepting new patients

Locations

1372 Peachtree St NE
Ste 100
Atlanta, GA 30309
Phone (470) 964-1700

1404 River Pl
Ste 501
Braselton, GA 30517
Phone (770) 212-3268

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

9019 Overlook Blvd
Ste C1B
Brentwood, TN 37027

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1306450390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782195",
            "telephone_number": "770-979-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Clinic #4507",
            "address_2": "103 JESSE JEWELL PKWY SW",
            "address_purpose": "LOCATION",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "country_code": "US",
            "telephone_number": "770-536-3441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4130 Bridle Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300246030",
            "country_code": "US",
            "telephone_number": "678-205-7857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1404 River Pl Ste 501",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-534-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUKUMAR",
        "first_name": "BINDUMOLE",
        "middle_name": "A",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN202370",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN202370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.