Dian Joan Cullion, PA-C
Individual provider Active NPI Medical Physician Assistant · Johnston, RI
NPI 1972551489 · NPPES record last updated Dec 6, 2020
Key facts
- NPI
- 1972551489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA00100 (RI)
- Practice address
- 1524 Atwood Ave Ste 322
Johnston, RI 02919-3228 - Phone
- (508) 340-1579
- Fax
- (774) 565-0469
- NPI assigned
- May 5, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080319000657 | RI | Practitioner - Physician Assistant | 3779535869 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00100 | RI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Community Action, Inc | Current |
Accepting new patients | |
| Comprehensive Community Action, Inc. | Current |
Accepting new patients | |
| Atmed Primary Care Inc. | Past |
Accepting new patients | |
| Blackstone Valley Community Health Care, Inc. | Past | Accepting new patients | |
| Shawn a Howland MD | Past |
Accepting new patients |
Locations
311 Doric Ave
Cranston, RI 02910
Phone (401) 467-9610
1090 Cranston St
Cranston, RI 02920
Phone (401) 467-9610
2756 Post Rd
Ste 103
Warwick, RI 02886
Phone (401) 384-6007
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA00100 | RI | Yes |
Addresses
Primary practice location
1524 Atwood Ave Ste 322
Johnston, RI 02919-3228
Mailing address
881 Greenwich Ave Unit 30
Warwick, RI 02886-1870
Phone (401) 295-5982
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2501291 | Other | RI | UNITED HEALTH |
| 9004005 | Medicaid | RI | |
| 412907 | Other | RI | BLUE CHIP |
| 29928 | Other | RI | BLUE CROSS |
Other providers in Johnston, RI
- Arthur J Corvese
- Julie Lynn Costa
- Crescent Medical Center LLC
- Hannah Creta
- Clinton C. Crete
- Stephanie Curry
- Cyril O. Burke III, M.D.
- John Czerwein Jr.
- Vincent D'Alessandro
- Amanda D'Ercole
All providers in Johnston, RI · Medical Physician Assistant in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2020. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.