Judith A Cullom, BA

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3903 Indianapolis Blvd
East Chicago, IN 46312-2555

Phone

(219) 398-7050

Fax

(219) 392-6998

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164590907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 LOUISIANA ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106385",
            "telephone_number": "219-757-1924",
            "fax_number": "219-757-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 INDIANAPOLIS BLVD",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463122555",
            "telephone_number": "219-398-7050",
            "fax_number": "219-392-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLOM",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "BA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.