BRYAN T SULLIVAN
NPI 1235209115
Podiatrist in Jackson, MS

Q: What is Mississippi Foot And Surgical Center, LLC's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Active since November 08, 2006CLIA 25D0970399 · Waiver

1915 DUNBARTON DRIVE, JACKSON, MS 39216(601) 982-3338(601) 982-2253 Get Directions Write a Review

NPPES record last updated: June 19, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Bryan T Sullivan NPPES

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

BRYAN T SULLIVAN (NPI 1235209115) is a healthcare organization registered as a podiatrist in Jackson, Mississippi and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through February 13, 2028 and lists Bryan Tipton Sullivan, Owner, as its authorized official.

NPPES Registry Identity

NPI1235209115

Entity TypeOrganization

Primary Taxonomy213E00000X

Legal Business NameMISSISSIPPI FOOT AND SURGICAL CENTER, LLC

Location Address1915 DUNBARTON DRIVEJackson, MS 39216

Mailing Address1915 Dunbarton DriveJackson, MS 39216 · (601) 982-3338 · Fax (601) 982-2253

Phone(601) 982-3338

Fax(601) 982-2253

Organization SubpartNo

Authorized OfficialBryan Tipton SullivanOwner · (601) 982-3338

Enumeration DateNovember 8, 2006

Last NPPES UpdateJune 19, 2008

✔ NPI 1235209115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers

Taxonomy Code213E00000X

License✔ Licensed in MS · 80089

Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

1915 DUNBARTON DRIVE, Jackson, MS 39216

Open in Google Maps ↗

Other Names 1

Doing Business AsBryan T Sullivan

Other Identifiers 4

Medicaid00012910MS

Medicare ID-Type Unspecified490000020

Medicare UPINT11696

Other480007636Railroad Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 25D0970399

Mississippi Foot And Surgical Center · Jackson, MS

Active · expires Feb 13, 2028

CLIA Number25D0970399

Laboratory TypeOther

Certificate Effective DateFebruary 14, 2026

Certificate Expiration DateFebruary 13, 2028

Laboratory DirectorDr. Bryan T. Sullivan

Laboratory Phone(601) 982-3338

Laboratory LocationMississippi Foot And Surgical Center1915 Dunbarton Drive, Jackson, MS 39216

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.

BRYAN TIPTON SULLIVAN DPM

Podiatrist

1915 DUNBARTON DRIVE
JACKSON, MS 39216

Hinds County (601) 982-3338

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 Mississippi Foot And Surgical Center, LLC's NPI number?

The NPI number for Mississippi Foot And Surgical Center, LLC is 1235209115. It was assigned to this organization in the NPPES registry on November 8, 2006. The provider is doing business as Bryan T Sullivan.

Where is Mississippi Foot And Surgical Center, LLC located?

Mississippi Foot And Surgical Center, LLC is located at 1915 Dunbarton Drive, Jackson, MS 39216. The listed phone number is (601) 982-3338.

What is Mississippi Foot And Surgical Center, LLC's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Does Mississippi Foot And Surgical Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D0970399) is associated with this NPI, valid through February 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mississippi Foot And Surgical Center, LLC was last updated on June 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.