Bryan Tipton Sullivan, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

80089 Issued in MS

Practice address

1915 Dunbarton Drive
Jackson, MS 39216

Phone

(601) 982-3338

Fax

(601) 982-2253

NPI assigned

Nov 8, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1986

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• Mississippi Methodist Rehab Ctr Hospital, Jackson, MS, CCN 250152

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bryantsullivandpm@mfc-ms.direct.office.nextgen.com

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.

• Mississippi Foot and Surgical Center, LLC

  • Podiatrist
  • Jackson, MS
  • NPI 1235209115
  NPD (past) Authorized official
• Anesthesia Consultants PA

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1750300836
  NPD (past)

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Tupelo, MS
  • NPI 1205604071

  Hospital

  Care Compare affiliation
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1841349792
  Care Compare affiliation

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1164592044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 DUNBARTON DRIVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-982-3338",
            "fax_number": "601-982-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 DUNBARTON DRIVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-982-3338",
            "fax_number": "601-982-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRYAN",
        "middle_name": "TIPTON",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MS",
            "license": "80089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00012910",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480007636",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Mixon Sugg, MD
• Margie Jeanann Suggs, M.D.
• Hamdi Sukkarieh, M.D.
• Anju Pokkaruparambil Sukumaran, MD
• Barbara D Sullivan, MD
• Carrington Sullivan
• Elizabeth Meade Sullivan
• John Magruder Sullivan III, MD
• Kimberly Simmons Sullivan, MD
• Lisa Myers Sullivan, MD

• Podiatrist in Jackson, MS
• Providers in Jackson, MS by specialty
• Podiatrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.