Stephanie Grace Sullivan, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR008394 Issued in GA

Practice address

113 Oak Laurel
Woodstock, GA 30188-6721

Phone

(770) 757-0048

NPI assigned

Jan 7, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wellness Wagon Chiropractic, LLC

  • Clinic/Center
  • Woodstock, GA
  • NPI 1245477637
  NPD (past) Authorized official

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1629215009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 OAK LAUREL",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886721",
            "telephone_number": "770-757-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 OAK LAUREL",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886721",
            "telephone_number": "770-757-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "STEPHANIE",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Stulak, LPC
• Ian Sturn, DDS
• Tiffany Styles, NP
• Deborah Elizabeth Styron, P.T.
• Sullivan Chiropractic LLC
• Summit Surgical Partners, LLC
• Superior Healthcare LLC
• Superior Healthcare of Woodstock LLC
• Darren Michael Surma, D.C.
• Susan R. Rudnicki, PH.D., P.C.

• Chiropractor in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.