Individual provider Active NPI

Jessieca Danielle Sullivan, MA, CPT

  • Phlebotomy Technician
  • Jonesboro, GA
National Provider Identifier
1811867732
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
Practice address
118 North Ave Ste J
Jonesboro, GA 30236-8408
Phone
(404) 203-7342
NPI assigned
Nov 6, 2025
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X Primary

Addresses

Primary practice location

118 North Ave Ste J
Jonesboro, GA 30236-8408

Mailing address

1953 Valley Woods Dr
Riverdale, GA 30296-1883
Phone (404) 203-7342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Strictly Phlebotomy Atl Phlebotomy CurrentSince Nov 9, 2025 Accepting new patients

Locations

118 North Ave
Ste J
Jonesboro, GA 30236
Phone (404) 203-7342

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1811867732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 VALLEY WOODS DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961883",
            "telephone_number": "404-203-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NORTH AVE STE J",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302368408",
            "telephone_number": "404-203-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JESSIECA",
        "middle_name": "DANIELLE",
        "credential": "MA, CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.