{"npi":"1164592044","type":"NPI-1","status":"active","name":{"display":"Bryan Sullivan DPM","other":[],"first":"BRYAN","last":"SULLIVAN","middle":"TIPTON","credential":"DPM"},"specialty":{"primary_taxonomy":"213E00000X","primary_taxonomy_description":"Podiatry","slug":"podiatry","schema_org_specialty":"Podiatric","all":[{"code":"213E00000X","description":"Podiatry","primary":true,"state":"MS","license":"80089"}]},"addresses":[{"purpose":"LOCATION","street_1":"1915 DUNBARTON DRIVE","city":"JACKSON","state":"MS","postal_code":"39216","country_code":"US","phone":"6019823338","fax":"6019822253"},{"purpose":"MAILING","street_1":"1915 DUNBARTON DRIVE","city":"JACKSON","state":"MS","postal_code":"39216","country_code":"US","phone":"6019823338","fax":"6019822253"}],"license":{"state":"MS","number":"80089"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"00012910","state":"MS","issuer":null},{"type_code":"01","label":"Other","value":"480007636","state":null,"issuer":"RAILROAD MEDICARE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20080821000621","type_code":"14-48","type_desc":"PRACTITIONER - PODIATRY","state":"MS","pac_id":"1658446885"},{"enrlmt_id":"O20100930073477","type_code":"30-48","type_desc":"DME SUPPLIER - PHYSICIAN - PODIATRY","state":"MS","pac_id":"5991825481"}]},"enumeration_date":"2006-11-08","last_updated":"2008-06-05","_meta":{"source":"NPPES","snapshot_date":"2008-06-05","doc_url":"https://findmynpi.com/api"}}