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KEVIN SULLIVAN
NPI 1003497801
Pediatrics in Kennesaw, GA

Active since April 14, 2021PECOS Enrolled
3150 COBB PKWY NW STE 130, KENNESAW, GA 30152(770) 966-0778 Get Directions Write a Review

NPPES record last updated: February 26, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 26, 2025, Apr 14, 2021 (2 updates tracked since 2021).

About Kevin Sullivan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN SULLIVAN (NPI 1003497801) is an individual pediatrics provider in Kennesaw, Georgia, licensed in Georgia (101921) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003497801
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameKEVIN SULLIVAN
Location Address3150 COBB PKWY NW STE 130Kennesaw, GA 30152-1007
Mailing Address3664 Outlook Ct NeMarietta, GA 30066-1788 · (678) 478-0853
Phone(770) 966-0778
Sole ProprietorNo
Enumeration DateApril 14, 2021
Last NPPES UpdateFebruary 26, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 26, 2025
✔ NPI 1003497801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in GA · 101921
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3150 COBB PKWY NW STE 130, Kennesaw, GA 30152
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Sullivan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30152 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Sullivan's NPI number?

The NPI number for Kevin Sullivan is 1003497801. It was assigned to this individual provider in the NPPES registry on April 14, 2021.

Where is Kevin Sullivan located?

Kevin Sullivan practices at 3150 Cobb Pkwy NW Ste 130, Kennesaw, GA 30152. The listed phone number is (770) 966-0778.

What is Kevin Sullivan's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kevin Sullivan enrolled in Medicare?

Yes. Kevin Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Sullivan was last updated on February 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.