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SPENCER K SULLIVAN MD
NPI 1073735114
Pediatrics - Pediatric Hematology-Oncology in Madison, MS

Active since May 02, 2007PECOS Enrolled
7730 OLD CANTON RD BLDG B, MADISON, MS 39110(601) 499-0935(601) 499-0936 Get Directions Write a Review

NPPES record last updated: April 14, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 30, 2024, Apr 18, 2024, Jun 18, 2019 (3 updates tracked since 2019).

About Spencer K Sullivan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPENCER K SULLIVAN MD (NPI 1073735114) is an individual pediatric hematology-oncology provider in Madison, Mississippi, licensed in Mississippi (23304) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073735114
Entity TypeIndividualMale
Primary Taxonomy2080P0207X
Provider Legal NameSPENCER K SULLIVANCredential: MD
Location Address7730 OLD CANTON RD BLDG BMadison, MS 39110-9299
Mailing Address7731 Old Canton Rd Ste BMadison, MS 39110-6115 · (601) 499-0935 · Fax (601) 499-0936
Phone(601) 499-0935
Fax(601) 499-0936
Sole ProprietorNo
Enumeration DateMay 2, 2007
Last NPPES UpdateApril 14, 20253 updates tracked since enumeration
NPPES CertifiedApril 14, 2025
✔ NPI 1073735114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0207X
License✔ Licensed in MS · 23304
Definition

A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

7730 OLD CANTON RD BLDG B, Madison, MS 39110
Open in Google Maps ↗

Other Identifiers 1

Medicaid01212067MS

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Spencer K Sullivan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
27 services15 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
20 services13 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
19 services14 patients

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISSISSIPPI CENTER FOR ADVANCED MEDICINE, PC
Durable Medical Equipment & Medical Supplies
7730 OLD CANTON RD BLDG B
MADISON, MS 39110
Madison County (601) 499-0935
DR. PATRICIA HONEA STEWART M.D.
Allergy & Immunology
7730 OLD CANTON RD BLDG B
MADISON, MS 39110
Madison County (601) 499-0935
DR. NATALIE ETHRIDGE RUDSENSKE MD
Allergy & Immunology
7730 OLD CANTON RD BLDG B
MADISON, MS 39110
Madison County (601) 499-0935

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 Spencer Sullivan's NPI number?

The NPI number for Spencer Sullivan is 1073735114. It was assigned to this individual provider in the NPPES registry on May 2, 2007.

Where is Spencer Sullivan located?

Spencer Sullivan practices at 7730 Old Canton Rd Bldg B, Madison, MS 39110. The listed phone number is (601) 499-0935.

What is Spencer Sullivan's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Is Spencer Sullivan enrolled in Medicare?

Yes. Spencer Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Spencer Sullivan was last updated on April 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.