Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

CALLIE REBECCA SULLIVAN DNP, ARNP
NPI 1265051767
Nurse Practitioner - Family in Carrollton, GA

Active since April 14, 2020PECOS EnrolledAccepts Medicare Assignment
119 AMBULANCE DR, CARROLLTON, GA 30117(770) 812-5837(770) 812-5838 Get Directions Write a Review

NPPES record last updated: July 9, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 9, 2026, Oct 23, 2020, Apr 14, 2020 (3 updates tracked since 2020).

About Callie Rebecca Sullivan Dnp, Arnp NPPES

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

CALLIE REBECCA SULLIVAN DNP, ARNP (NPI 1265051767) is an individual family provider in Carrollton, Georgia, licensed in Georgia (NP325416) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1265051767
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCALLIE REBECCA SULLIVANCredential: DNP, ARNP
Location Address119 AMBULANCE DRCarrollton, GA 30117-3867
Mailing Address119 Ambulance DrCarrollton, GA 30117-3867 · (770) 812-5837 · Fax (770) 812-5838
Fax(770) 812-5838
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateApril 14, 2020
Last NPPES UpdateJuly 9, 20263 updates tracked since enumeration
NPPES CertifiedJuly 9, 2026
NPI 1265051767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in GA · NP325416
119 AMBULANCE DR, Carrollton, GA 30117

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

Callie Rebecca Sullivan Dnp, Arnp 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 ID6305276627
PECOS Enrollment IDI20250111000171
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 30117 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 5

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

Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
1 supplier11 claims1,120 services$0.37 avg. paid by Medicare
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6209
DME-Medical/Surgical Supplies · category DA023N
1 supplier13 claims205 services$7.23 avg. paid by Medicare
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212
DME-Medical/Surgical Supplies · category DA023N
1 supplier16 claims230 services$8.47 avg. paid by Medicare
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6402
DME-Medical/Surgical Supplies · category DA023N
1 supplier16 claims1,280 services$0.11 avg. paid by Medicare
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446
DME-Medical/Surgical Supplies · category DA023N
1 supplier17 claims1,416 services$0.38 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics
119 AMBULANCE DR, SUITE 202
CARROLLTON, GA 30117
Nurse Practitioner (Family)
119 AMBULANCE DR, SUITE 202
CARROLLTON, GA 30117
Clinic/Center (Radiology)
119 AMBULANCE DR
CARROLLTON, GA 30117

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265051767, enumerated as an "individual" on April 14, 2020.

The provider is located at 119 AMBULANCE DR CARROLLTON, GA 30117 and the phone number is (770) 812-5837.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.