Erin Bardonner Sustachek, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

GAA-NP001149 Issued in GA

Practice address

210 Oakside LN
Canton, GA 30114-6417

Phone

(678) 807-1050

Fax

(770) 720-7384

NPI assigned

Jan 19, 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

• Erin Marie Bardonner Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• Georgia Highlands Medical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Cumming, GA
  • NPI 1174529192
  Medicare reassignment NPD
• Georgia Highlands Medical Services Inc

  • Federally Qualified Health Center (FQHC)
  • Buford, GA
  • NPI 1427762707
  NPD
• Georgia Highlands Medical Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Canton, GA
  • NPI 1811501455
  NPD
• Georgia Highlands Medical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Canton, GA
  • NPI 1063419422
  NPD (past)

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1952016396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300280307",
            "telephone_number": "770-887-1668",
            "fax_number": "770-781-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 OAKSIDE LN",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301146417",
            "telephone_number": "678-807-1050",
            "fax_number": "770-720-7384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Oakside Ln",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301146413",
            "country_code": "US",
            "telephone_number": "678-807-1050",
            "fax_number": "770-720-7384",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 Dahlonega St",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300402110",
            "country_code": "US",
            "telephone_number": "770-887-1668",
            "fax_number": "770-781-9937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUSTACHEK",
        "first_name": "ERIN",
        "middle_name": "BARDONNER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "GAA-NP001149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "BARDONNER",
            "middle_name": "MARIE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Superior Healthcare LLC
• Superior Healthcare of Canton, LLC
• Bharat Surani, D.O
• Sure Path Wellness and Psychotherapy, LLC
• Suresight and Associates L L C
• Megan Lena Wander Suter, CPNP-PC
• Joshua V Swain
• Swan Counseling and Coaching, LLC
• Swords and Phelps
• Edwin Ira Swords III, D.D.S.

• Pediatric Nurse Practitioner in Canton, GA
• Providers in Canton, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.