Mary Ellen Cullom, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101049366 Issued in VA

Practice address

11800 Rock Landing Dr
Newport News, VA 23606-4206

Phone

(757) 643-8800

Fax

(757) 643-8919

NPI assigned

Jan 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcullom11630@direct.rivhs.com

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.

• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1194929026
  Medicare reassignment NPD
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Williamsburg, VA
  • NPI 1083867311
  NPD
• Riverside Physician Services, Inc.

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1710020623

  Ophthalmology

  NPD
• Riverside Physician Services Inc

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1013933977
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1275503864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 ROCK LANDING DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064206",
            "telephone_number": "757-643-8800",
            "fax_number": "757-643-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLOM",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101049366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275503864",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheryl Cruz
• CS Management Services LLC
• Nicole Yvette Cuffee, FNP
• Douglas Culbert, PT
• Elizabeth Cullipher
• Stephen H Cummings, MD
• Jason Allen Cummins, PA-C
• Amy Christine Cunningham, CRNA
• Shannon Paige Cunningham, MSN, PMHNP-BC
• Lewis H. Curd Jr., M.D.

• Ophthalmology Physician in Newport News, VA
• Providers in Newport News, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.