Individual provider Active NPI

Cass M Cullis, MD

  • Cardiovascular Disease Physician
  • Troy, OH
National Provider Identifier
1982607172
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35.041154 Issued in OH
Practice address
3006 N County Road 25a
Ste 104
Troy, OH 45373-1373
Phone
(937) 335-3518
Fax
(937) 332-6857
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35.041154 OH Primary

Addresses

Primary practice location

3006 N County Road 25a
Ste 104
Troy, OH 45373-1373

Mailing address

3006 N County Road 25a
Ste 104
Troy, OH 45373-1373
Phone (937) 335-3518

Other identifiers 1

IdentifierTypeStateIssuer
0472939MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.041154OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Care Inc PastSince Oct 1, 1991 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1982607172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 N COUNTY ROAD 25A",
            "address_2": "STE 104",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731373",
            "telephone_number": "937-335-3518",
            "fax_number": "937-332-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 N COUNTY ROAD 25A",
            "address_2": "STE 104",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731373",
            "telephone_number": "937-335-3518",
            "fax_number": "937-332-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLIS",
        "first_name": "CASS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.041154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0472939",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.