DR. MANLY JACKSON SULLIVAN MEDICAL DOCTOR
NPI 1003804352
Emergency Medicine in Carrollton, AL
About Dr. Manly Jackson Sullivan Medical Doctor NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MANLY JACKSON SULLIVAN MEDICAL DOCTOR (NPI 1003804352) is an individual emergency medicine provider in Carrollton, Alabama, licensed in Alabama (20081) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (1995).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Manly Jackson Sullivan Medical Doctor is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Manly Sullivan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fayette, AL 35555
- Reassigned Medicare billing, Alabama enrollment
- 78 clinicians in this Medicare group
Winfield, AL 35594
- Reassigned Medicare billing, Alabama enrollment
- 18 clinicians in this Medicare group
Haleyville, AL 35565
- Reassigned Medicare billing, Alabama enrollment
- 40 clinicians in this Medicare group
Haleyville, AL 35565
- Reassigned Medicare billing, Alabama enrollment
- 56 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 35447 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CARROLLTON, AL 35447
CARROLLTON, AL 35447
CARROLLTON, AL 35447
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Manly Sullivan's NPI number?
The NPI number for Manly Sullivan is 1003804352. It was assigned to this individual provider in the NPPES registry on October 11, 2005.
Where is Manly Sullivan located?
Manly Sullivan practices at 241 Robert K Wilson Dr, Carrollton, AL 35447. The listed phone number is (205) 367-2408.
What is Manly Sullivan's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Manly Sullivan enrolled in Medicare?
Yes. Manly Sullivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Manly Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Manly Sullivan reassigns Medicare benefits to 4 organizations: Relias Emergency Medicine Specialists Of Fayette, LLC (Fayette, AL), Nwmc Emergency Physicians LLC (Winfield, AL), Sycamore Lakeland LLC (Haleyville, AL) and Lakeland Physicians LLC (Haleyville, AL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Manly Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Manly Sullivan accept?
Health plans from Blue Cross and Blue Shield of Alabama list Manly Sullivan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Manly Sullivan was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Manly Jackson Sullivan, MEDICAL DOCTOR · NPI 1003804352
Emergency Medicine physician in Carrollton, Alabama. Individual provider, active in the CMS NPPES registry since October 11, 2005.
## Identity
- **NPI:** 1003804352 (Entity type: Individual)
- **Enumerated:** October 11, 2005
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 20081 (Alabama)
- **Sole proprietor:** No
## Practice location
- **Address:** 241 ROBERT K WILSON DR, Carrollton, AL 35447-8010
- **Phone:** (205) 367-2408 · **Fax:** (205) 367-9123
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Relias Emergency Medicine Specialists Of Fayette, LLC (NPI 1093201543, Fayette, AL); Nwmc Emergency Physicians LLC (NPI 1134708506, Winfield, AL); Sycamore Lakeland LLC (NPI 1184472789, Haleyville, AL); Lakeland Physicians LLC (NPI 1851780951, Haleyville, AL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Alabama School Of Medicine, class of 1995
## Record status
- **NPPES last updated:** July 13, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1003804352) · Data from the CMS NPPES public registry.