JONATHAN CULLIS (NPI# 1053721480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053721480 |
| Entity Type | Individual |
| Full Name | JONATHAN CULLIS |
| Credential | PHARM. D. |
| Practice Address |
4200 Conestoga Dr Springfield IL 62711-7962 |
| Mailing Address |
57 Providence Ln Springfield IL 62711 |
| Practice Telephone | 2175472410 |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2014-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
051.297101 | IL | Pharmacy Service Providers |
| Street Address |
4200 CONESTOGA DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62711-7962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013287853 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 4200 Conestoga Dr, Springfield, IL 62711-7962 | 2012-01-11 |
| 1023517109 | Paula Kay Hubbard | Nurse Practitioner | 4200 Conestoga Dr, Springfield, IL 62711-7962 | 2018-02-05 |
| 1265965800 | Juliet Anne Oury | Nurse Practitioner | 4200 Conestoga Dr, Springfield, IL 62711-7962 | 2017-04-11 |
| 1760925697 | Landon Conrad | Pharmacist | 4200 Conestoga Dr, Springfield, IL 62711-7962 | 2016-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
| 1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
| 1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
| 1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
| 1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
| 1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
| 1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
| 1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
| Find all providers in zip 62711 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609150564 | Steve C Platou | Pharmacist | 2159 S. Campbell Ave, Springfield, MO 65807 | 2011-10-10 |
| 1295018422 | Gregory James Serocki | Pharmacist | 3189 S Woodstock Ave, Springfield, MO 65809-4146 | 2011-09-23 |
| 1306995378 | Chad Michael Graue | Pharmacist | 7409 Piper Glen Dr, Springfield, IL 62711-7092 | 2007-01-09 |
| 1437235314 | Scott Bergman | Pharmacist | 701 N 1st St # 19636, Siu Infectious Diseases, Springfield, IL 62702-3757 | 2006-10-31 |
| 1083695811 | John Mark Ruscin | Pharmacist | 701 N. First Street, Springfield, IL 62794-9636 | 2005-11-09 |
| 1104427624 | Lee Owen Cunningham | Pharmacist | 323 E Grand St, Springfield, MO 65807-1447 | 2020-11-02 |
| 1093316515 | Susan B Nutter | Pharmacist | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-11-02 |
| 1740802263 | Linda Pien | Pharmacist | 6501 Loisdale Ct, Springfield, VA 22150-1826 | 2020-05-07 |
| 1700423910 | Jennifer Marie Anna Smola | Pharmacist | 3300 Main St Ste 2a, Springfield, MA 01199-1002 | 2019-12-06 |
| 1922546001 | Terri Cook | Pharmacist | 2730 Gateway St, Springfield, OR 97477 | 2017-02-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62711 |
Please comment or provide details below to improve the information on JONATHAN CULLIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.