Lee Richard Sullivan, AGNPC-AG

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN213335 Issued in GA

Practice address

1765 Old West Broad St
Athens, GA 30606-2853

Phone

(706) 549-1663

Fax

(706) 546-8792

NPI assigned

May 14, 2017

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

Electronic endpoints 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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athens Orthopedic Clinic, PAGroup PAC ID 5991600181, 70 clinicians

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary'S Hospital Hospital, Athens, GA, CCN 110006
• Elbert Memorial Hospital Hospital, Elberton, GA, CCN 111337
• Ty Cobb Regional Medical Center, LLC Hospital, Lavonia, GA, CCN 110027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lsullivan@aoc1036.srs-direct.com
• Direct secure messaging: lee.sullivan.1@28045.direct.athenahealth.com

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.

• Athens Orthopedic Clinic, PA

  • Orthopaedic Surgery Physician
  • Athens, GA
  • NPI 1063495299
  Medicare reassignment Care Compare group NPD
• Athens Orthopedic Clinic, PA

  • Orthopaedic Surgery Physician
  • Greensboro, GA
  • NPI 1104219468
  NPD
• Pediatric Orthopedic Associates

  • Pediatric Radiology Physician
  • Salt Lake City, UT
  • NPI 1659488799
  NPD (past)

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

• Elbert Memorial Hospital

  • Critical Access Hospital
  • Elberton, GA
  • NPI 1669488250
  Care Compare affiliation
• St. Mary'S Hospital, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1871556621
  Care Compare affiliation
• St. Mary'S Sacred Heart Hospital, Inc.

  • Rural Acute Care Hospital
  • Lavonia, GA
  • NPI 1518354778
  Care Compare affiliation

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

{
    "created_epoch": "1494720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1326575952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST BLDG 2-200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062887",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062853",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 King Ave",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306066734",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Elberton",
            "state": "GA",
            "postal_code": "306351833",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1774 Old West Broad St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062865",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LEE",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "AGNPC-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-14",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN213335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "14182507",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lee.sullivan.1@28045.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address",
            "address_1": "1765 Old West Broad St",
            "city": "Athens",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306062853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Scott Sudderth, LPC
• Melisa Ann Suggs, FNP
• Suitable for the People Health Service, LLC
• Erin Elizabeth Sullivan, DNP, FNP-BC
• James Deal Sullivan, MD
• Summit BHC Monroe, LLC
• Summit Clinical Research LLC
• Sundance Rehabilitation Agency, LLC
• Surgery Center of Athens LLC
• Kinjal Suthar, MD

• Acute Care Nurse Practitioner in Athens, GA
• Providers in Athens, 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 Mar 11, 2024; 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.