Cardinal Clinical Consulting, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CARDINAL CLINICAL CONSULTING, LLC

Practice address

2625 Traceland Dr Ste B
Tupelo, MS 38801-4240

Phone

(662) 269-3599

Fax

(662) 259-2503

NPI assigned

May 28, 2019

Last updated

May 28, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joshua C Fulwiler, PHDNPI 1841674645

Title

Owner

Phone

(662) 269-3599

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joshua Campbell Fulwiler, PHD

  • Clinical Psychologist
  • Tupelo, MS
  • NPI 1841674645
  Medicare reassignment NPD Authorized official
• Christian S Courson, PH.D.

  • Psychologist
  • Omaha, NE
  • NPI 1881248516
  NPD (past)

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559001600000",
    "number": "1417514274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 TRACELAND DR STE B",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014240",
            "telephone_number": "662-269-3599",
            "fax_number": "662-259-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 TRACELAND DR STE B",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014240",
            "telephone_number": "662-269-3599",
            "fax_number": "662-259-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL CLINICAL CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-28",
        "last_updated": "2019-05-28",
        "status": "A",
        "authorized_official_last_name": "FULWILER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-269-3599",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Williamson Cannon
• Kaye B Cannon, OTRL CHT
• Susie Shantila Cannon, TRADITIONAL MIDWIFE
• John A Cantrell, M.D.
• Caitlyn Capps, M.S.,NCC,LPC/MHSP-T
• Cardiology Associates of North Ms PA
• Cardiosom, LLC (CardioSom of Tupelo)
• Cardiothoracic Surgery Clinic of North Ms
• Caring Hands Health Care Services
• Caring Hands Healthcare

• Clinical Psychologist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Clinical Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.