Individual provider Active NPI

David M Sullivan, M.D.

  • Internal Medicine Physician
  • Madison, MS
National Provider Identifier
1386751329
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10794 Issued in MS
Practice address
106 Highland Way Ste 200
Madison, MS 39110-6933
Phone
(601) 200-4141
Fax
(601) 200-4150
NPI assigned
Aug 24, 2006
Last updated
Aug 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10794 MS Primary

Addresses

Primary practice location

106 Highland Way Ste 200
Madison, MS 39110-6933

Mailing address

PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4749

Other practice location 1

971 Lakeland Dr Ste 250
Jackson, MS 39216-4620
Phone (601) 200-4860

Other identifiers 1

IdentifierTypeStateIssuer
00018138MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.49 of 100Reported as group
Quality
72.89
Promoting interoperability
100
Improvement activities
40
Cost
72.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1386751329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23666",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253666",
            "telephone_number": "601-200-4749",
            "fax_number": "601-200-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 HIGHLAND WAY STE 200",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106933",
            "telephone_number": "601-200-4141",
            "fax_number": "601-200-4150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "971 Lakeland Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164620",
            "country_code": "US",
            "telephone_number": "601-200-4860",
            "fax_number": "601-200-4887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "10794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018138",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.