Individual provider Active NPI

Craig M Cullum

  • Peer Specialist
  • Cincinnati, OH
National Provider Identifier
1376415711
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
APS.006858 Issued in OH
Practice address
1501 Madison Rd
Cincinnati, OH 45206
Phone
(513) 354-5200
NPI assigned
Sep 23, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X APS.006858 OH Primary

Addresses

Primary practice location

1501 Madison Rd
Cincinnati, OH 45206

Mailing address

1501 Madison Rd
Cincinnati, OH 45206
Phone (513) 354-5200

Other practice location 1

1088 Wasserman Way
Batavia, OH 45103
Phone (513) 735-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APS.006858OHMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Clermont Recovery Center, Inc. Past Accepting new patients

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": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1376415711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45206",
            "telephone_number": "513-354-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45206",
            "telephone_number": "513-354-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1088 WASSERMAN WAY",
            "address_purpose": "LOCATION",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "45103",
            "country_code": "US",
            "telephone_number": "513-735-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CULLUM",
        "first_name": "CRAIG",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS.006858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.