Drake Hunter Cullum, MD
Individual provider Active NPI Internal Medicine Physician · Gravette, AR
NPI 1841829751 · NPPES record last updated Oct 17, 2023
Key facts
- NPI
- 1841829751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- E-16840 (AR)
- Practice address
- 1101 Jackson St SW
Gravette, AR 72736-9121 - Phone
- (479) 787-5291
- NPI assigned
- Apr 2, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Arkansas College of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sgoh Acquisition Inc
Practice addresses (Care Compare)
1101 Jackson St SW
Gravette, AR 72736-9121
Phone (479) 787-5291
346 N Main St
Och Decatur Clinic
Decatur, AR 72722-9732
Phone (479) 752-3233
Hospital & facility affiliations
- Ozarks Community Hospital of Gravette
- Mercy Hospital Northwest Arkansas
- Northwest Medical Center-Springdale
- Ozarks Community Hospital of Gravette
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230911004278 | AR | Practitioner - Internal Medicine | 4284063587 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sgoh Acquisition Inc | Current |
Accepting new patients | |
| Sgoh Acquisition Inc | Current |
Accepting new patients | |
| Sgoh Acquisition Inc | Past | Accepting new patients |
Locations
346 N Main St
Decatur, AR 72722
Phone (479) 752-3233
1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | E-16840 | AR | Yes |
Addresses
Primary practice location
1101 Jackson St SW
Gravette, AR 72736-9121
Mailing address
1101 Jackson St SW
Gravette, AR 72736-9121
Phone (479) 787-5221
Other providers in Gravette, AR
- Carla Sawatski Cheek
- City of Gravette
- Joy Ann Coonfield
- Daniel Hunt Cooper
- Anna Mae Cowgur
- Frederick Nicholas Day III
- Jackie Suzanne Day
- Designed for Life Counseling & Consulting Services, PLLC
- Rayetta Eaton
- Samantha Jean Eaton
All providers in Gravette, AR · Internal Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.