John Magruder Sullivan III, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

T-3879 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-1000

NPI assigned

Jul 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Plastic and Reconstructive Surgery

Education

University of Mississippi School of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plastic Surgery Center of Hattiesburg, PLLCGroup PAC ID 6103921986, 3 clinicians

Wesley Physician Services LLCGroup PAC ID 2466559851, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health Wesley Hospital, Hattiesburg, MS, CCN 250094

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• LA PPO C-SNP

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1930/brand/2/csg/102/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Plastic Surgery Center of Hattiesburg, PLLC

  • Plastic Surgery Physician
  • Hattiesburg, MS
  • NPI 1396895413
  Medicare reassignment Care Compare group NPD
• Wesley Physician Services LLC

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1538200209
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wesley Health System LLC

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1841241841
  Care Compare affiliation

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1043872948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 ENCLAVE CIR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574522",
            "telephone_number": "601-953-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOHN",
        "middle_name": "MAGRUDER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MS",
            "license": "T-3879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmsullivan@umc.edu",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2500 N State St",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anju Pokkaruparambil Sukumaran, MD
• Barbara D Sullivan, MD
• Bryan Tipton Sullivan, DPM
• Carrington Sullivan
• Elizabeth Meade Sullivan
• Kimberly Simmons Sullivan, MD
• Lisa Myers Sullivan, MD
• Madison Brooke Sullivan
• Mark Sullivan
• Molly Sullivan

• Plastic and Reconstructive Surgery Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Plastic and Reconstructive Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.