NPIMap

Organization Active NPI

Deepthi S Cull MD PA

Doing business as Avant-Garde Medicine

  • Physical Medicine & Rehabilitation Physician
  • North Smithfield, RI
National Provider Identifier
1518559236
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
DEEPTHI S CULL MD PA
Doing business as
Avant-Garde Medicine
Practice address
116 Eddie Dowling Hwy
North Smithfield, RI 02896-7327
Phone
(401) 769-2200
NPI assigned
Feb 4, 2021
Last updated
Sep 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Authorized official

Name
Dr. Deepthi S Cull, MDNPI 1497749113
Title
President
Phone
(847) 767-0137

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

116 Eddie Dowling Hwy
North Smithfield, RI 02896-7327

Mailing address

4225 Lincolnshire Dr Ste B
Mount Vernon, IL 62864-2157
Phone (618) 242-2317

Other practice location 1

115 Cass Ave
Woonsocket, RI 02895-4705
Phone (401) 769-4100

Other names 1

  • Avant-Garde Medicine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1518559236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 LINCOLNSHIRE DR STE B",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642157",
            "telephone_number": "618-242-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 EDDIE DOWLING HWY",
            "city": "NORTH SMITHFIELD",
            "state": "RI",
            "postal_code": "028967327",
            "telephone_number": "401-769-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Cass Ave",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028954705",
            "country_code": "US",
            "telephone_number": "401-769-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DEEPTHI S CULL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "CULL",
        "authorized_official_first_name": "DEEPTHI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-767-0137",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avant-Garde Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avant-Garde Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Smithfield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.