DR. BETH ANN SULLIVAN (NPI# 1669476388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669476388 |
| Entity Type | Individual |
| Full Name | DR. BETH ANN SULLIVAN |
| Other Name | DR. BETH ANN CORNISH |
| Credential | DO |
| Practice Address |
1960 Riverside Pkwy Ste 106 Lawrenceville GA 30043-5945 |
| Practice Telephone | 6784072222 |
| Mailing Telephone | 6784072222 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2014-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 049106 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000888698D | 05 | |
| GA | SOUTHCARE ID | 54305 | 01 |
| GA | AETNA PROVIDER ID | 7393382 | 01 |
| GA | 85002412G | 05 | |
| GA | 327120 | 05 | |
| GA | 10041812 | 05 | |
| GA | BCBSGA PROVIDER ID | 903825 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265093090 | Beth Ann Sullivan | Occupational Therapist | 2305 Rancocas Rd, Burlington, NJ 08016-4113 | 2019-06-24 |
| 1093002453 | Beth Anna Sullivan | Pediatrics | 1 Childrens Plz, Dayton, OH 45404-1898 | 2011-07-06 |
| 1255624391 | Beth Sullivan | Social Worker | 5 Hall Ave, Somerville, MA 02144-2003 | 2011-05-23 |
| 1588986947 | Beth Ellen Sullivan | Specialist | 3703 W Lake Ave, Suite200, Glenview, IL 60026-1223 | 2010-02-25 |
| 1427280726 | Beth Carriere Sullivan | Nurse Practitioner | 1525 Dickory Ave, New Orleans, LA 70123-2168 | 2009-08-20 |
| 1790995744 | Beth Sullivan | Acupuncturist | 535 H St, Chula Vista, CA 91910-4301 | 2007-05-22 |
| 1760558175 | Beth Louise Sullivan | Counselor | 2611 12th St S, Wisconsin Rapids, WI 54494 | 2006-11-28 |
| Street Address |
1960 RIVERSIDE PKWY STE 106 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30043-5945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023369477 | Melanie Becker Lopez | Nurse Practitioner | 1960 Riverside Pkwy, Suite 101, Lawrenceville, GA 30043-5945 | 2012-09-25 |
| 1427344746 | Marissa Cook Sheridan | Nurse Practitioner | 1960 Riverside Pkwy, Suite 101, Lawrenceville, GA 30043-5945 | 2011-06-24 |
| 1467780007 | Amy Wellington | Physical Therapist | 1960 Riverside Pkwy, Suite 104, Lawrenceville, GA 30043-5945 | 2009-11-19 |
| 1811155823 | Elizabeth J Nerren | Audiologist | 1960 Riverside Pkwy, Suite 101, Lawrenceville, GA 30043-5945 | 2008-05-27 |
| 1689847923 | Ann C Czabala | Occupational Therapist | 1960 Riverside Pkwy, Suite 104, Lawrenceville, GA 30043-5945 | 2008-04-08 |
| 1114147774 | Hand Therapy Specialists, Inc. | Specialist | 1960 Riverside Pkwy, Suite 104, Lawrenceville, GA 30043-5945 | 2007-04-26 |
| 1679658702 | Gwinnett Infectious Diseases PC | Internal Medicine | 1960 Riverside Pkwy, Suite 101, Lawrenceville, GA 30043-5945 | 2006-10-26 |
| 1619980893 | Tzvetan Vassilev | Internal Medicine | 1960 Riverside Pkwy, Suite 101, Lawrenceville, GA 30043-5945 | 2006-08-15 |
| 1952318602 | Paul D Martin | Internal Medicine | 1960 Riverside Pkwy, Suite 101, Lawrenceville, GA 30043-5945 | 2006-08-02 |
| 1912913740 | Elliot G Raizes | Internal Medicine | 1960 Riverside Pkwy, Suite 101, Lawrenceville, GA 30043-5945 | 2006-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609483882 | Brittany Javier Dunn | Counselor | 2387 Lawrenceville Huntcrest Way, Lawreneville, GA 30043 | 2020-09-30 |
| 1629614037 | Terrea Gina Bridges | Behavior Technician | 2387 Huntcrest Rd, Lawrenceville, GA 30043 | 2019-11-20 |
| 1215581756 | Elegant Lm Management, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1020 Meadowsong Circle, Lawrenceville, GA 30043 | 2019-08-01 |
| 1093299778 | Shareef Nahas | Clinical Medical Laboratory | 1130 Hurricane Shoals Rd, Suite 1800, Lawrenceville, GA 30043 | 2018-09-19 |
| 1649766874 | Nutritionecw LLC | Dietitian, Registered | 1755 North Brown Rd, Ste.200, Lawrenceville, GA 30043 | 2018-07-11 |
| 1962997965 | David Le Nguyen | Dentist | 2000 Riverside Pkwy Ste 200, Lawrenceville, GA 30043 | 2018-06-22 |
| 1932611688 | Asfc Outreach Therapeutic Counseling Services, LLC | Counselor | 1755 North Brown Road, Suite 200, Lawrenceville, GA 30043 | 2017-11-02 |
| 1518486810 | Shira Brey Williams | Specialist/Technologist | 1030 Collins Hill Rd, Lawrenceville, GA 30043 | 2017-09-18 |
| 1700300795 | Nympha J. Mathurin Meadows | Behavioral Analyst | 650 Oxford Crest Ct, Lawrenceville, GA 30043 | 2017-08-01 |
| 1992245591 | Jagruti Chaudhari | Nurse Practitioner | 855 Buford Drive, Lawrenceville, GA 30043 | 2017-03-01 |
| Find all providers in zip 30043 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669989422 | Choicemed Inc | Family Medicine | 3545 Cruse Rd Ste 100, Lawrenceville, GA 30044-3169 | 2018-01-02 |
| 1356705768 | Mark Adam Theodore Molckovsky | Family Medicine | 32 East Lawrence Road, Lawrenceville, PA 16929 | 2016-04-12 |
| 1902290570 | New League Family Practice | Family Medicine | 428 Waterbury Dr, Lawrenceville, GA 30046-3323 | 2015-03-23 |
| 1114347580 | Tik Pau | Family Medicine | 665 Duluth Hwy Ste 501, Lawrenceville, GA 30046-8709 | 2014-04-23 |
| 1346687696 | Paul Andrew Robertson | Family Medicine | 825 Meadowsong Cir, Lawrenceville, GA 30043-4236 | 2013-05-28 |
| 1952667388 | Alfred B. Amendolara Md, PC | Family Medicine | 2380 Lawrenceville Rd, Lawrenceville, NJ 08648 | 2012-04-10 |
| 1013200096 | Sana Rabbi | Family Medicine | 455 Philip Blvd, Ste 130, Kaiser Permanente Lawrenceville Medical Office, Lawrenceville, GA 30046 | 2011-05-24 |
| 1992021232 | Community Family Practice and Urgent Care P C | Family Medicine | 277 E Crogan St, Lawrenceville, GA 30046-5054 | 2010-04-12 |
| 1013148626 | Sheila Kennedy | Family Medicine | 1430 Five Forks Trickum Rd St 220, Lawrenceville, GA 30044-8182 | 2009-07-30 |
| 1366628117 | Nazra Baluch | Family Medicine | 1692 Atkinson Park Cir, Lawrenceville, GA 30043-7937 | 2008-01-10 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30043 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.