Individual provider Active NPI

Michelle Cullen, F.N.P.

  • Family Nurse Practitioner
  • Oxford, MS
National Provider Identifier
1063645166
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R857620 Issued in MS
Practice address
1109 N Lamar Blvd
Suite 1
Oxford, MS 38655-2861
Phone
(662) 238-7860
Fax
(662) 238-7871
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R857620 MS Primary

Addresses

Primary practice location

1109 N Lamar Blvd
Suite 1
Oxford, MS 38655-2861

Mailing address

1109 N Lamar Blvd
Suite 1
Oxford, MS 38655-2861
Phone (662) 238-7860

Other identifiers 1

IdentifierTypeStateIssuer
03428243MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100308000775 MS Practitioner - Nurse Practitioner 8628113164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oxford Family Clinic,LLC Family CurrentSince Nov 24, 2009 Accepting new patients

Locations

1109 N Lamar Blvd
Ste 1
Oxford, MS 38655
Phone (662) 238-7860

1914 University Ave
Oxford, MS 38655
Phone (662) 238-7860

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1063645166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N LAMAR BLVD",
            "address_2": "SUITE 1",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386552861",
            "telephone_number": "662-238-7860",
            "fax_number": "662-238-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N LAMAR BLVD",
            "address_2": "SUITE 1",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386552861",
            "telephone_number": "662-238-7860",
            "fax_number": "662-238-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "MICHELLE",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R857620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03428243",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.