Tyler Olivia Sumner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2346 Issued in AL

Practice address

1700 Center St
Mobile, AL 36604-3301

Phone

(251) 415-1000

Fax

(251) 415-1001

NPI assigned

Mar 7, 2023

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 names 1

• Ms. Tyler Olivia Scoggins Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• USA Health Physician Billing Services LLC

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1720645468
  Medicare reassignment NPD
• USA Health Physician Billing Services LLC

  dba USA Radiology

  • Diagnostic Radiology Physician
  • Mobile, AL
  • NPI 1609434067
  NPD

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1548960651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "866-401-3057",
            "fax_number": "318-868-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CENTER ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366043301",
            "telephone_number": "251-415-1000",
            "fax_number": "251-415-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "TYLER",
        "middle_name": "OLIVIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "2346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYLER",
            "last_name": "SCOGGINS",
            "middle_name": "OLIVIA",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kirstan Sullivan
• Linda Sullivan, CRNP
• Mary Katherine Elizabeth Sullivan, LCSW, LICSW
• Rogan Sullivan
• Timmany Sullivan
• Carol Barbour Sumrall, LPC
• Sunbelt Patient Solutions LLC (SOS Mobile Medical Care)
• Sunbelt Research Group, LLC
• Sunlife Wellness & Hydration, LLC
• Sunrise Dermatology

• Physician Assistant in Mobile, AL
• Providers in Mobile, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.