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SUSAN BUTLER SUMNER M.D.
NPI 1205896305
Family Medicine in Cave Spring, GA

Active since March 24, 2006PECOS EnrolledAccepts Medicare Assignment
28 ROME RD, CAVE SPRING, GA 30124(706) 777-8775 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 6, 2026, Jan 24, 2023 (2 updates tracked since 2023).

About Susan Butler Sumner M.d. NPPES

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

SUSAN BUTLER SUMNER M.D. (NPI 1205896305) is an individual family medicine provider in Cave Spring, Georgia, licensed in Georgia (29851) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS, is affiliated with Redmond Regional Medical Center, and is a graduate of Medical College Of Georgia School Of Medicine (1982).

NPPES Registry Identity

NPI1205896305
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSUSAN BUTLER SUMNERCredential: M.D.
Location Address28 ROME RDCave Spring, GA 30124-0000
Mailing Address28 Rome RdCave Spring, GA 30124-0000 · (706) 777-8775
Phone(706) 777-8775
Sole ProprietorYes
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1982
Enumeration DateMarch 24, 2006
Last NPPES UpdateApril 6, 20262 updates tracked since enumeration
NPPES CertifiedApril 6, 2026
✔ NPI 1205896305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in GA · 29851✔ Licensed in GA · 01201822021
Definition
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.
28 ROME RD, Cave Spring, GA 30124
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Other Identifiers 2

Medicaid008704420AL
Medicaid00344825AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Blue Cross and Blue Shield of Alabama.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Susan Butler Sumner M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032253356
PECOS Enrollment IDI20100224000306
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.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
469 services28 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
332 services26 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
119 services42 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
53 services28 patients
Testing for presence of drug, read by direct observation 80305
Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.
48 services17 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
43 services29 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Redmond Regional Medical Center

Acute Care Hospitals · Rome, GA
4/5 CMS rating
OwnershipProprietary
CMS Certification Number110168
Location501 Redmond Road NWRome, GA 30165 · Floyd County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30124 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
4 suppliers17 claims32 services$1.23 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers16 claims16 services$23.41 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers34 claims35 services$5.87 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers37 claims37 services$89.58 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$32.77 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
2 suppliers26 claims1,530 services$4.52 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Susan Butler Sumner's NPI number?

The NPI number for Susan Butler Sumner is 1205896305. It was assigned to this individual provider in the NPPES registry on March 24, 2006.

Where is Susan Butler Sumner located?

Susan Butler Sumner practices at 28 Rome Rd, Cave Spring, GA 30124. The listed phone number is (706) 777-8775.

What is Susan Butler Sumner's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Susan Butler Sumner enrolled in Medicare?

Yes. Susan Butler Sumner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Susan Butler Sumner accept?

Health plans from Alliant Health Plans, Inc. and Blue Cross and Blue Shield of Alabama list Susan Butler Sumner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Susan Butler Sumner affiliated with any hospitals?

According to CMS data, Susan Butler Sumner is affiliated with Redmond Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Susan Butler Sumner was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.