Heeers, PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

13888 Issued in MS

Legal business name

HEEERS, PA

Doing business as

Sullivan Family Medicine Clinic

Practice address

1814 Hospital Dr
Jackson, MS 39204-3410

Phone

(601) 373-2940

Fax

(601) 373-2720

NPI assigned

Jun 23, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Hursie J Davis-Sullivan, M.D.NPI 1912104159

Title

Owner and President

Phone

(601) 373-2940

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sullivan Family Medicine Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hursie J Davis-Sullivan, M.D.

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1912104159
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1215933346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 HOSPITAL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043410",
            "telephone_number": "601-373-2940",
            "fax_number": "601-373-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 HOSPITAL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043410",
            "telephone_number": "601-373-2940",
            "fax_number": "601-373-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEEERS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS-SULLIVAN",
        "authorized_official_first_name": "HURSIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER AND PRESIDENT",
        "authorized_official_telephone_number": "601-373-2940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "13888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08236531",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00112110",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sullivan Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heaven Cynt Services LLC
• Heavenly Touch Homecare LLC
• Michael C Hebert, MD
• Emily Eileen Hecox, MD
• Susan Blanton Hedgepeth
• Mohamed Hegazy
• Yassmin Hegazy, MD
• Jennifer Clair Heggie, LPC-S, NCC
• Amy Heidelberg, FNP-C
• Philip Heine, PT

• Clinic/Center in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.