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SULLIVAN FAMILY MEDICINE CLINIC
NPI 1215933346
Clinic/Center in Jackson, MS

Active since June 23, 2005CLIA 25D1011770 · Waiver
1814 HOSPITAL DR, JACKSON, MS 39204(601) 373-2940(601) 373-2720 Get Directions Write a Review

NPPES record last updated: November 9, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sullivan Family Medicine Clinic NPPES

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

SULLIVAN FAMILY MEDICINE CLINIC (NPI 1215933346) is a healthcare organization registered as a clinic/center in Jackson, Mississippi and active in the NPI registry since June 2005. The organization holds a CLIA Waiver certificate valid through April 20, 2027 and lists Hursie J Davis-sullivan, Owner And President, as its authorized official.

NPPES Registry Identity

NPI1215933346
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameHEEERS, PA
Location Address1814 HOSPITAL DRJackson, MS 39204-3410
Mailing Address1814 Hospital DrJackson, MS 39204-3410 · (601) 373-2940 · Fax (601) 373-2720
Phone(601) 373-2940
Fax(601) 373-2720
Organization SubpartNo
Authorized OfficialHursie J Davis-sullivanOwner And President · (601) 373-2940
Enumeration DateJune 23, 2005
Last NPPES UpdateNovember 9, 2010
✔ NPI 1215933346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in MS · 13888
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1814 HOSPITAL DR, Jackson, MS 39204
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Other Names 1

Doing Business AsSullivan Family Medicine Clinic

Other Identifiers 5

Medicare ID-Type UnspecifiedC02914MS
Medicaid00112110MS
Medicaid08236531MS
Medicare UPINF65463MS
Medicare ID-Type Unspecified080003184MS · Hursie Davis-sullivan

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D1011770

Sullivan Family Medicine Clinic · Jackson, MS
Active · expires Apr 20, 2027
CLIA Number25D1011770
Laboratory TypePhysician Office
Certificate Effective DateApril 21, 2025
Certificate Expiration DateApril 20, 2027
Laboratory DirectorHursie J. Davis-Sullivan
Laboratory Phone(601) 373-2940
Laboratory LocationSullivan Family Medicine Clinic1814 Hospital Drive, Jackson, MS 39204
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DR. HURSIE J DAVIS-SULLIVAN M.D.
Family Medicine
1814 HOSPITAL DR
JACKSON, MS 39204
Hinds County (601) 373-2940

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 Heeers, PA's NPI number?

The NPI number for Heeers, PA is 1215933346. It was assigned to this organization in the NPPES registry on June 23, 2005. The provider is doing business as Sullivan Family Medicine Clinic.

Where is Heeers, PA located?

Heeers, PA is located at 1814 Hospital Dr, Jackson, MS 39204. The listed phone number is (601) 373-2940.

What is Heeers, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Heeers, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D1011770) is associated with this NPI, valid through April 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Heeers, PA was last updated on November 9, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years 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.