MS. JERRY SULLIVAN CFNP
NPI 1457409807
Nurse Practitioner - Family in Woodland, MS
About Ms. Jerry Sullivan Cfnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. JERRY SULLIVAN CFNP (NPI 1457409807) is an individual family provider in Woodland, Mississippi, licensed in Mississippi (R739537) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1994).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
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
Ms. Jerry Sullivan Cfnp 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 Reassignment
Medicare enrollment records show Jerry Sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Woodland, MS 39776
- Reassigned Medicare billing, Mississippi enrollment
- 3 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39776 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 5
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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 Jerry Sullivan's NPI number?
The NPI number for Jerry Sullivan is 1457409807. It was assigned to this individual provider in the NPPES registry on January 8, 2007.
Where is Jerry Sullivan located?
Jerry Sullivan practices at 120 Market Street, Woodland, MS 39776. The listed phone number is (662) 456-0111.
What is Jerry Sullivan's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jerry Sullivan enrolled in Medicare?
Yes. Jerry 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 organization bills Medicare for Jerry Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jerry Sullivan reassigns Medicare benefits to Woodland Clinic LLC (Woodland, MS). The 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 Jerry Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jerry Sullivan accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Jerry 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 Jerry Sullivan was last updated on February 17, 2011. 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.
# Ms. Jerry Sullivan, CFNP · NPI 1457409807
Family physician in Woodland, Mississippi. Individual provider, active in the CMS NPPES registry since January 8, 2007.
## Identity
- **NPI:** 1457409807 (Entity type: Individual)
- **Enumerated:** January 8, 2007
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** R739537 (Mississippi)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 120 MARKET STREET, Woodland, MS 39776
- **Phone:** (662) 456-0111 · **Fax:** (662) 456-7335
## 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:** Woodland Clinic LLC (NPI 1629282330, Woodland, MS), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1994
## Record status
- **NPPES last updated:** February 17, 2011
- **Other identifiers:** Medicare UPIN S69279 (MS); Medicare PIN 258937 (MS); Medicaid 0114346 (MS)
---
Source: [NPI Profile](https://npiprofile.com/npi/1457409807) · Data from the CMS NPPES public registry.