Kip C Cullimore, M.D.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

ME0071841 Issued in FL

Practice address

8381 Riverwalk Park Blvd
Suite 101
Fort Myers, FL 33919-8760

Phone

(239) 936-5425

Fax

(239) 936-5176

NPI assigned

Mar 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

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

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00020

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.

• Associates in Dermatology M D P L

  • Procedural Dermatology Physician
  • Fort Myers, FL
  • NPI 1811950371
  Medicare reassignment NPD

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1831150507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8381 RIVERWALK PARK BLVD",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198760",
            "telephone_number": "239-936-5425",
            "fax_number": "239-936-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8381 RIVERWALK PARK BLVD",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198760",
            "telephone_number": "239-936-5425",
            "fax_number": "239-936-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLIMORE",
        "first_name": "KIP",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME0071841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5762385",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070009505",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF FLA",
            "identifier": "32504",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5361863002",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Cuesta-Repice
• Sara Cuesta, RBT
• Asia Ariel Culbreth
• Tessa Culhane
• Jason Cullen, MD
• Morgan Cullinan
• Jamie Harmon Culpepper, LMT
• Kaleb Logan Culpepper, DO
• Keegan Rose Culver, PSY.D.
• Duane F Cumberbatch, D.P.M.

• Procedural Dermatology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Procedural Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.