Jimmy Brian Sullivan, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

12808 Issued in TX

Practice address

1540 Rice Rd Ste 400
Tyler, TX 75703-3223

Phone

(903) 597-9021

NPI assigned

Feb 9, 2015

Sex

Male

Sole proprietor

Yes

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 TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Four-Ten Enterprise, LLC

  dba Helping Hands Chiropractic

  • Chiropractor
  • Tyler, TX
  • NPI 1619497401
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1619368941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 RICE RD STE 400",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033223",
            "telephone_number": "903-597-9021",
            "fax_number": "903-597-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 RICE RD STE 400",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033223",
            "telephone_number": "903-597-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JIMMY",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-09",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "583300AC3Z",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nadin Suleiman
• Karsyn Briana Sulewski, PTA
• Zeelan Suleyman
• Abdelrazig B Suliman, M.D
• Tyler Sullins, LPC
• Michael A Sullivan, PA
• William Mark Sullivan, R.PH.
• Kimberly J Sulser
• Norman Carl Sulser, M.D.
• Mohammad Tanvir Sultan, D.O.

• Chiropractor in Tyler, TX
• Providers in Tyler, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.