Kevin Sullivan

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

82648 Issued in GA

Practice address

541 Historic Highway 441
Demorest, GA 30535

Phone

(706) 839-4000

NPI assigned

Jul 1, 2014

Last updated

Aug 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Hospitalist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Hospitalist Physicians LLCGroup PAC ID 1951299163, 503 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Piedmont Hospitalist Physicians LLC

  • Family Medicine Physician
  • Stockbridge, GA
  • NPI 1548219660
  Medicare reassignment Care Compare group NPD
• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212
  Medicare reassignment NPD
• Covenant Medical Center, Inc.

  dba Covenant HealthCare

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1972590412
  Medicare reassignment NPD
• Mercy Memorial Hospital Corporatio

  dba Promedica Monroe Regional Hospital

  • General Acute Care Hospital
  • Monroe, MI
  • NPI 1811097223
  Medicare reassignment NPD
• Covenant Medical Center, Inc

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1619412376
  NPD
• Covenant Medical Center, Inc.

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1366597544
  NPD
• Mercy Memorial Hospital Corporation

  dba Monroe Cancer Center

  • Specialist
  • Monroe, MI
  • NPI 1376997551
  NPD
• Mercy Memorial Hospital Corporation

  dba Family Medicine Residency Center

  • Family Medicine Physician
  • Monroe, MI
  • NPI 1659614022
  NPD

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

• Piedmont Newnan Hospital, Inc.

  • General Acute Care Hospital
  • Newnan, GA
  • NPI 1134133002
  Care Compare affiliation

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1346656170",
    "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": "541 HISTORIC HIGHWAY 441",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "30535",
            "telephone_number": "706-839-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Stewart Rd",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "MI",
            "postal_code": "481624222",
            "country_code": "US",
            "telephone_number": "734-240-8430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301106158",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "82648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grayson Smith
• Anny Sosebee, NP-C
• James E Spoden, M.D.
• Kevin Aaron Stadlbauer, PT, DPT
• Kaye Herrin Stanley, PT
• Shana Alaine Sumner, MS, RD, LD
• Ravin Batuk Talati, M.D
• Kelly Elizabeth Taylor, ANP
• Kristie D Taylor, NP-C
• Semere Tesfamariam, MD

• Hospitalist Physician in Demorest, GA
• Providers in Demorest, GA by specialty
• Hospitalist Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.