Sunrise Detox Duluth, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SUNRISE DETOX DULUTH, LLC

Practice address

3390 N Berkeley Lake Rd NW
Duluth, GA 30096-3006

Phone

(561) 318-4400

NPI assigned

Apr 25, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Jason Usilton

Title

Director of RCM

Phone

(561) 318-4400

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theresa Graham, LPC

  • Professional Counselor
  • Alpharetta, GA
  • NPI 1487387908
  Medicare reassignment NPD
• Thomas J. Locke III, MD

  • General Practice Physician
  • Alpharetta, GA
  • NPI 1558595066
  Medicare reassignment NPD
• Chanya M Peters, APRN-BC

  • Nurse Practitioner
  • Marietta, GA
  • NPI 1629246038
  Medicare reassignment NPD
• Natacha Smith

  • Psychiatric/Mental Health Nurse Practitioner
  • Norcross, GA
  • NPI 1003298035
  Medicare reassignment NPD
• Amanda Jeanne Legg, MS, ADC

  • Counselor
  • Duluth, GA
  • NPI 1790117877
  NPD
• Meghean Turner

  • Mental Health Counselor
  • Duluth, GA
  • NPI 1881329258
  NPD
• Stephanie Lauren Dyar

  • Addiction (Substance Use Disorder) Counselor
  • Duluth, GA
  • NPI 1821939844

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1649914813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 10TH AVE N STE 300",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616612",
            "telephone_number": "561-318-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 N BERKELEY LAKE RD NW",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963006",
            "telephone_number": "561-318-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE DETOX DULUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "USILTON",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "561-318-4400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Surgery Center of Duluth
• Jimin Sun
• Kyung-Hwa Sun
• Sung Hyun Inc
• Sunrise Detox Duluth Ga, LLC
• Brandon Supak
• Surgical
• Surgical Assistants of America, Inc.
• Margaret Sutcliffe
• Payal Suthar, D.O.

• Substance Abuse Rehabilitation Facility in Duluth, GA
• Providers in Duluth, GA by specialty
• Substance Abuse Rehabilitation Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.