Mullissa Childress CCM Medical Services

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MULLISSA CHILDRESS CCM MEDICAL SERVICES

Doing business as

CCM Medical Services

Practice address

222 S Rainbow Blvd Ste 115
Las Vegas, NV 89145-5126

Phone

(702) 406-4125

NPI assigned

Jun 26, 2017

Organization subpart

No

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

Authorized official

Name

Mullissa Michelle Childress, APRN

Title

Nurse Practitioner Provider

Phone

(702) 406-4125

Specialties & licenses 3

Addresses

Other names 1

• CCM Medical Services Doing business as

Locations

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1073033528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 BRIGHT SUN CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89130",
            "telephone_number": "614-496-8420",
            "fax_number": "702-745-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S RAINBOW BLVD STE 115",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891455126",
            "telephone_number": "702-406-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULLISSA CHILDRESS CCM MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-26",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "CHILDRESS",
        "authorized_official_first_name": "MULLISSA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER PROVIDER",
        "authorized_official_telephone_number": "702-406-4125",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCM Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaitlynn Marie Mullins
• Katrina Mullins
• Lakisha Mullins
• Madison Mullins
• Shawn Mullins
• Darlene K Mullon, M.D.
• George Peter Mulopulos, M.D.
• Carolyn M. Mulroney, MD
• Multi Wave Therapy Eswt, LLC
• Multicultural Counseling Collaborative, Inc.

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.