NPIMap

Organization Active NPI

Mississippi Burn, Hand and Reconstruction Centers PC

  • Specialist
  • Jackson, MS
National Provider Identifier
1699484816
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MISSISSIPPI BURN, HAND AND RECONSTRUCTION CENTERS PC
Practice address
1225 N State St Ste 103
Jackson, MS 39202-2064
Phone
(833) 672-8767
Fax
(800) 967-9562
NPI assigned
Nov 16, 2022
Last updated
Apr 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Authorized official

Name
Derek Culnan, MDNPI 1396951620
Title
Owner
Phone
(833) 672-8767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Specialist 174400000X Primary

Addresses

Primary practice location

1225 N State St Ste 103
Jackson, MS 39202-2064

Mailing address

PO Box 2204
Madison, MS 39130-2204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221213000536 MS Part B Supplier - Clinic/Group Practice 2163891268 Receives reassigned benefits from 16 practitioners
Practice locations: Jackson, MS
O20250217000017 MS DME Supplier - Physician - General Surgery 2163891268 Practice locations: Jackson, MS

National Provider Directory

National Provider Directory

Locations

1225 N State St
Ste 103
Jackson, MS 39202
Phone (769) 268-6520

1225 N State St
Ste 1101
Jackson, MS 39202

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1699484816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2204",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391302204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N STATE ST STE 103",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022064",
            "telephone_number": "833-672-8767",
            "fax_number": "800-967-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI BURN, HAND AND RECONSTRUCTION CENTERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "CULNAN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "833-672-8767",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.