Scott Sullivan, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

63308 Issued in TN

Practice address

1432 Kimbrough Rd
Germantown, TN 38138-2405

Phone

(901) 767-4499

NPI assigned

May 11, 2017

Last updated

Feb 18, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MS, TN, AR3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Ophthalmology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charles Retina Institute PCGroup PAC ID 9830002583, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital Hospital, Memphis, TN, CCN 440183

Merit-based Incentive Payment System (MIPS)

Final score

91.36 of 100Reported as group

Quality

82.73

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: scottsullivan@nmhs.medalliesdirect.net
• Direct secure messaging: ssullivan33497@mlh.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charles Retina Institute PC

  • Specialist
  • Germantown, TN
  • NPI 1477556306

  AR, MS

  Medicare reassignment Care Compare group NPD
• St Bernards Hospital Inc.

  dba St Bernards Medical Center

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1396053096
  Medicare reassignment NPD
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD

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

• Amisub (SFH), Inc.

  dba St. Francis Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1952326977
  Care Compare affiliation

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1689100471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 KIMBROUGH RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382405",
            "telephone_number": "901-767-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 KIMBROUGH RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382405",
            "telephone_number": "901-767-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "63308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Michael Sturdivant, M.D.
• Emily Elizabeth Suffridge
• Ashley Barker Sugg, CRNA
• Donald J Sullivan, MD
• Mariam M Sullivan, MD
• Margaret Zavada Summitt, MD
• Robert Summitt, MD
• Shantel Sunny
• Sutherland Cardiology Clinic, P.C.
• Leslie M Sutton, OTR/L, CHT

• Retina Specialist (Ophthalmology) Physician in Germantown, TN
• Providers in Germantown, TN by specialty
• Retina Specialist (Ophthalmology) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.