Jacqueline R Sulton, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

027675 Issued in GA

Practice address

2258 Northlake Pkwy
Suite 100
Tucker, GA 30084-4019

Phone

(770) 670-6100

Fax

(470) 359-5996

NPI assigned

Aug 31, 2005

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FBHCDD/Endpoint/FBHCDD

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.

• The Sulton Pediatric Group, PC

  • Pediatrics Physician
  • Lithonia, GA
  • NPI 1003075003
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1326031741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2258 NORTHLAKE PKWY",
            "address_2": "SUITE 100",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844019",
            "telephone_number": "770-670-6100",
            "fax_number": "470-359-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2258 NORTHLAKE PKWY",
            "address_2": "SUITE 100",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844019",
            "telephone_number": "770-670-6100",
            "fax_number": "470-359-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTON",
        "first_name": "JACQUELINE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "027675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000307304D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adetrice Shawnte Strown, MSN,APRN, PMHNP-BC
• Brenda Strozier
• Peggy A Studstill-Horansky, LCSW
• Jon H Sudman, MD
• David D Suh, MD
• Summit Care LLC
• Sunrise Medical Company LLC
• Kyle Sussenbach
• Jenna Leigh Swartzberg, CCC-SLP
• Lisa Anne Swift, APRN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.