DR. JIMMY BRIAN SULLIVAN DC
NPI 1619368941
Chiropractor in Tyler, TX
About Dr. Jimmy Brian Sullivan Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JIMMY BRIAN SULLIVAN DC (NPI 1619368941) is an individual chiropractor in Tyler, Texas, licensed in Texas (12808) and active in the NPI registry since February 2015. He is a graduate of Other (2013).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
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. Jimmy Brian Sullivan Dc 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 Jimmy Sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tyler, TX 75703
- Reassigned Medicare billing, Texas enrollment
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
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.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jimmy Sullivan's NPI number?
The NPI number for Jimmy Sullivan is 1619368941. It was assigned to this individual provider in the NPPES registry on February 9, 2015.
Where is Jimmy Sullivan located?
Jimmy Sullivan practices at 1540 Rice Rd Ste 400, Tyler, TX 75703. The listed phone number is (903) 597-9021.
What is Jimmy Sullivan's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Jimmy Sullivan enrolled in Medicare?
Yes. Jimmy 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 Jimmy Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jimmy Sullivan reassigns Medicare benefits to Four-Ten Enterprise, LLC (Tyler, TX). 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 Jimmy Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jimmy Sullivan accept?
Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Cigna Healthcare, Providence Health Plan and UnitedHealthcare list Jimmy 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 Jimmy Sullivan was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Dr. Jimmy Brian Sullivan, DC · NPI 1619368941
Chiropractor provider in Tyler, Texas. Individual provider, active in the CMS NPPES registry since February 9, 2015.
## Identity
- **NPI:** 1619368941 (Entity type: Individual)
- **Enumerated:** February 9, 2015
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** 12808 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1540 RICE RD STE 400, Tyler, TX 75703-3223
- **Phone:** (903) 597-9021
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Four-Ten Enterprise, LLC (NPI 1619497401, Tyler, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2013
## Record status
- **NPPES last updated:** January 17, 2023
- **Other identifiers:** Other 583300AC3Z (TX)
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Source: [NPI Profile](https://npiprofile.com/npi/1619368941) · Data from the CMS NPPES public registry.