David Wayne Sullivan, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

11785 Issued in MS

Practice address

6029 Walnut Grove Rd Ste 301
Memphis, TN 38120-2112

Phone

(901) 747-9081

Fax

(901) 747-9087

NPI assigned

Jul 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS, TN2 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 2

Specialty

Hematology/Oncology

Education

University of Mississippi School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Memorial Hospital Union County, Inc.Group PAC ID 4183601305, 41 clinicians

Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Baptist Memorial Hospital-Desoto, Inc.Group PAC ID 5597758755, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Union County Hospital, New Albany, MS, CCN 250006
• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Merit-based Incentive Payment System (MIPS)

Final score

82.54 of 100Reported as group

Quality

71.01

Promoting interoperability

100

Improvement activities

40

Cost

58.38

Merit-based Incentive Payment System (MIPS)

Final score

81.87 of 100Reported as group

Quality

64.75

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dsullivan25413@mlh.direct-ci.com
• Direct secure messaging: dsullivan14794@direct.bmhcc.org

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.

• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206

  Hematology & Oncology, MS

  Medicare reassignment Care Compare group NPD
• Baptist Memorial Hospital Union County, Inc.

  • General Acute Care Hospital
  • New Albany, MS
  • NPI 1780648352
  Medicare reassignment Care Compare group NPD
• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Medicare reassignment Care Compare group NPD
• Baptist Memorial Hospital-Tipton

  • General Acute Care Hospital
  • Covington, TN
  • NPI 1316901937
  Medicare reassignment NPD
• Baptist Memorial Hospital North Mississippi, Inc

  • General Acute Care Hospital
  • Oxford, MS
  • NPI 1053375576
  Medicare reassignment NPD
• Baptist Memorial Hospital-Tipton

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1114464211
  NPD
• Baptist Memorial Medical Group Inc

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1841006129
  NPD
• Baptist Memorial Hospital North Mississippi, Inc

  • Community/Retail Pharmacy
  • Oxford, MS
  • NPI 1477108322
  NPD
• Baptist Memorial Hospital-Desoto, Inc.

  • Community/Retail Pharmacy
  • Southaven, MS
  • NPI 1790669331
  NPD
• Baptist Memorial Health Services, Inc. of Mississippi

  • Internal Medicine Physician
  • New Albany, MS
  • NPI 1104971696
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

• Baptist Memorial Hospital Union County, Inc.

  • General Acute Care Hospital
  • New Albany, MS
  • NPI 1780648352
  Care Compare affiliation
• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Care Compare affiliation
• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439
  Care Compare affiliation

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1851399638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD STE 301",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202112",
            "telephone_number": "901-747-9081",
            "fax_number": "901-747-9087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "391 Southcrest Cir Ste 101",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386714848",
            "country_code": "US",
            "telephone_number": "662-349-0755",
            "fax_number": "662-349-0356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "20920",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MS",
            "license": "11785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDIARE",
            "identifier": "P00272099",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125865",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Claire Sullivan
• Anne Lorraine Self Sullivan, MD
• Catherine Brooke Sullivan, PHARM.D.
• Chuck Sullivan
• Courtney Sullivan
• Gwyneth A Sullivan
• Jasmine Alexandra Sullivan
• Joshua Wade Sullivan, PHARM.D.
• Mary Kathleen Sullivan, DNP, FNP, RN
• Meghan Dale Jackson Sullivan, M.D.

• Hematology & Oncology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Hematology & Oncology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.