Maria Sullivan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

540 Lake Center Pkwy
Suite 107
Cumming, GA 30040-7727

Phone

(770) 205-3939

NPI assigned

Aug 30, 2006

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

Practice roles

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.

• Champion Physical Therapy LLC

  • Physical Therapist
  • Cumming, GA
  • NPI 1053509299
  NPD (past)
• Sportscare Physical Therapy Inc

  • Physical Therapist
  • Suwanee, GA
  • NPI 1962459883
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1376653964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 PURPLE MARTIN TRCE",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419343",
            "telephone_number": "770-886-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LAKE CENTER PKWY",
            "address_2": "SUITE 107",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300407727",
            "telephone_number": "770-205-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "PTA001177",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veerappan Subramaniyam, M.D.
• Deepthi Sudhir, RBT
• Melanie Sugar, M.S., BCBA
• Hollie Krystal Suggs, LAPC
• Melissa Sulhoff, LPC
• Stephanie Tiv Sullivan, PA-C
• Jacob Summerford, PA-C
• Jessica Summers, RBT
• Kristin Bryson Summey, NP-C
• Laura Inman Sumpter, LCSW

• Physical Therapy Assistant in Cumming, GA
• Providers in Cumming, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.