Bradley F. Sumrall, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA00066 Issued in MS

Practice address

255 Baptist Blvd
Suite 401
Columbus, MS 39705-2011

Phone

(662) 244-2288

Fax

(662) 244-2289

NPI assigned

Jun 16, 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 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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• United Emergency Services of Mississippi

  • Emergency Medicine Physician
  • Columbus, MS
  • NPI 1801983309
  Medicare reassignment
• Columbus Emergency Services, LLC

  • Nurse Practitioner
  • Columbus, MS
  • NPI 1821056409
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1215971288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827",
            "telephone_number": "870-934-5821",
            "fax_number": "870-934-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 BAPTIST BLVD",
            "address_2": "SUITE 401",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052011",
            "telephone_number": "662-244-2288",
            "fax_number": "662-244-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMRALL",
        "first_name": "BRADLEY",
        "middle_name": "F.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MS",
            "license": "PA00066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04729081",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Danielle Styron, MS
• Sachin Subramani, MD
• William David Suclupe, LICSW
• Lauren B Sullivan
• Linda Gail Sumner
• Doyle F Sumrall, M.D.
• Minyoung Sung
• Surgery Clinic of Columbus PLLC
• Shelah Swart
• Pamela O Sykes, M.D.

• Surgical Physician Assistant in Columbus, MS
• Providers in Columbus, MS by specialty
• Surgical Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.