Charles S Cullison, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DO3314 Issued in NV

Practice address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600

Phone

(702) 653-2273

NPI assigned

Apr 4, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Emergency Medicine

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Team Physicians of Nevada-Scherr, PCGroup PAC ID 4082844147, 16 clinicians

Hoover Emergency Physicians LLCGroup PAC ID 0648450296, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Churchill Community Hospital Hospital, Fallon, NV, CCN 291313
• Boulder City Hospital Hospital, Boulder City, NV, CCN 291309

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Hoover Emergency Physicians LLC

  • Emergency Medicine Physician
  • Boulder City, NV
  • NPI 1063713790
  Medicare reassignment Care Compare group NPD
• Team Physicians of Nevada-Scherr, P.C.

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1073942116

  NV

  Medicare reassignment Care Compare group NPD

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

• Banner Churchill Community Hospital

  • Critical Access Hospital
  • Fallon, NV
  • NPI 1265811251
  Care Compare affiliation
• Boulder City Hospital Inc

  • Critical Access Hospital
  • Boulder City, NV
  • NPI 1881739613
  Care Compare affiliation

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1578025912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLISON",
        "first_name": "CHARLES",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T0457",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10066642",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "DO3314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Crosswhite, RD
• Eloisa Catherine Crouse, MD
• Michael William Cruciger, DDS
• Colt J Crutchfield, PA-C
• Venus Tamara Cruz, IDMT
• Braden Cunningham
• Kelsey Curtis
• Deanna M Daniels, LCSW
• Sylvester Dass
• Jason W David, MD

• Emergency Medicine Physician in Nellis Afb, NV
• Providers in Nellis Afb, NV by specialty
• Emergency Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.