Individual provider Active NPI

Cunardline Bienvenu-Sumpter, PA-C

  • Medical Physician Assistant
  • Norcross, GA
National Provider Identifier
1972685667
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
004913 Issued in GA
Practice address
2010 Beaver Ruin Rd
Norcross, GA 30071-3710
Phone
(770) 449-9050
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 004913 GA Primary

Addresses

Primary practice location

2010 Beaver Ruin Rd
Norcross, GA 30071-3710

Mailing address

7035 Hampton Bluff Way
Roswell, GA 30075-6747
Phone (770) 993-4492

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972685667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7035 HAMPTON BLUFF WAY",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300756747",
            "telephone_number": "770-993-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BEAVER RUIN RD",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300713710",
            "telephone_number": "770-449-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIENVENU-SUMPTER",
        "first_name": "CUNARDLINE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.