Individual provider Active NPI

Joshua Cullison, MD

  • Family Medicine Physician
  • Bloomfield, IN
National Provider Identifier
1245593300
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01075649A Issued in IN
Practice address
55 N Judge St Ste a
Bloomfield, IN 47424-1231
Phone
(812) 847-4481
NPI assigned
Jun 22, 2012
Last updated
May 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME156043 FL
Family Medicine Physician 207Q00000X 01075649A IN Primary

Addresses

Primary practice location

55 N Judge St Ste a
Bloomfield, IN 47424-1231

Mailing address

55 N Judge St
Bloomfield, IN 47424-1231
Phone (812) 847-4481

Other identifiers 1

IdentifierTypeStateIssuer
201332190MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240620001689 FL Practitioner - Family Practice 2466772942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lucie Medical Specialists LLCGroup PAC ID 1456430487, 39 clinicians

Practice addresses (Care Compare)

1881 SE Tiffany Ave
Port Saint Lucie, FL 34952-7567

2505 SW Martin Hwy
Palm City, FL 34990-3149
Phone (772) 288-1015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01075649AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lucie Medical Specialists LLC Family Medicine CurrentSince Aug 4, 2024 Accepting new patients
Lawnwood Cardiovascular Surgery LLC Past Accepting new patients
Greene County General Hospital LLC Family Medicine Past Accepting new patients

Locations

2505 SW Martin Hwy
Palm City, FL 34990
Phone (772) 288-0060

1881 SE Tiffany Ave
Ste 306
Port Saint Lucie, FL 34952
Phone (772) 398-7822

1881 SE Tiffany Ave
Ste 308
Port Saint Lucie, FL 34952
Phone (772) 398-7822

140 SW Chamber Ct
Ste 100
Port St Lucie, FL 34986
Phone (772) 355-9600

1881 SE Tiffany Ave
Ste 102
Port St Lucie, FL 34952
Phone (772) 398-7936

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: joshua.cullison@hca4.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
My Westgate ClinicNewberry, IN, CCN 158534 Rural health clinic W-2 Managing Employee Jan 1, 2020
Greene County General HospitalBloomfield, IN, CCN 158533 Rural health clinic W-2 Managing Employee Jan 1, 2020
My Worthington ClinicWorthington, IN, CCN 158538 Rural health clinic W-2 Managing Employee Jan 1, 2020
My Linton ClinicLinton, IN, CCN 158535 Rural health clinic W-2 Managing Employee Jan 1, 2020

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1245593300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 N JUDGE ST",
            "city": "BLOOMFIELD",
            "state": "IN",
            "postal_code": "474241231",
            "telephone_number": "812-847-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N JUDGE ST STE A",
            "city": "BLOOMFIELD",
            "state": "IN",
            "postal_code": "474241231",
            "telephone_number": "812-847-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLISON",
        "first_name": "JOSHUA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME156043",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01075649A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201332190",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, IN

Sources for this page

Verify at the official NPI Registry.