Sabra Sullivan, M.D., PHD.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

14238 Issued in MS

Practice address

100 Mannsdale Park Dr Ste 1
Madison, MS 39110-6381

Phone

(601) 910-3004

Fax

(601) 910-3005

NPI assigned

Mar 1, 2006

Sex

Female

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 MS

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 1

Specialty

Dermatology

Education

University of Texas Southwestern Medical School at Dallas, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Magnolia Dermatology, PLLCGroup PAC ID 0749576031, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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.

• Dermatology Associates LLC

  • Medical Specialty Clinic/Center
  • Jackson, MS
  • NPI 1235318874
  Medicare reassignment NPD Authorized official
• Magnolia Dermatology, PLLC

  • Dermatology Physician
  • Clinton, MS
  • NPI 1841645470
  Medicare reassignment Care Compare group NPD
• The Cutaneous Laser Center

  • Procedural Dermatology Physician
  • Jackson, MS
  • NPI 1487843199
  NPD (past) Authorized official
• Optical 2000

  • Optometrist
  • Clinton, MS
  • NPI 1144422577
  NPD (past)
• University Internal Medicine Assoc LLP

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1083656870
  NPD (past)

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1932176641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 HIGHWAY 80 E",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565252",
            "telephone_number": "601-910-3004",
            "fax_number": "601-910-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MANNSDALE PARK DR STE 1",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106381",
            "telephone_number": "601-910-3004",
            "fax_number": "601-910-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SABRA",
        "credential": "M.D., PHD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MS",
            "license": "14238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114928",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachael Stout, PMHNP-BC
• Jonathan Chandler Strain, PHARM D
• George Elder Stuart Jr., PT, DPT
• Miranda Street Sudduth, PA-C
• David M Sullivan, M.D.
• Spencer K Sullivan, MD
• Sonya Sebren Summerlin
• Summit Collaborative Care
• Summit Medical Solutions
• Kelsey Sumrall, PT

• Procedural Dermatology Physician in Madison, MS
• Providers in Madison, MS by specialty
• Procedural Dermatology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.