Cody Renaldo Gullick, FNP-C in Clarksdale, MS

Cody Renaldo Gullick, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Clarksdale, Mississippi. His current practice location is 619 S State St, Clarksdale, Mississippi. You can reach out to his office (for appointments etc.) via phone at (662) 812-1229.

Cody Renaldo Gullick is licensed to practice in Mississippi (license number 902905) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1205319530.

Contact Information

	Cody Renaldo Gullick, FNP-C
	619 S State St, Clarksdale, MS 38614-6319
	(662) 812-1229
	Not Available

Map and Direction

Provider's Profile

Full Name	Cody Renaldo Gullick
Gender	Male
Speciality	Nurse Practitioner - Family
Location	619 S State St, Clarksdale, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205319530
Provider Enumeration Date: 09/12/2018
Last Update Date: 09/12/2018

Medicare PECOS Information:

PECOS PAC ID: 3678826716
Enrollment ID: I20181019000351

Medical Identifiers

Medical identifiers for Cody Renaldo Gullick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205319530	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	902905 (Mississippi)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Cody Renaldo Gullick allows following entities to bill medicare on his behalf.

Entity Name	Mettetal Family Medicince
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083786727 PECOS PAC ID: 3072591791 Enrollment ID: O20040709000707

Entity Name	Family First Clinic Of Clarksdale Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215206016 PECOS PAC ID: 6800054297 Enrollment ID: O20120214000472

Entity Name	Fast Pace Mississippi Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447769559 PECOS PAC ID: 3678832029 Enrollment ID: O20180111000291

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Cody Renaldo Gullick is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Cody Renaldo Gullick, FNP-C 214 Cedar Hts, Pope, MS 38658-2875 Ph: (662) 812-1229	Cody Renaldo Gullick, FNP-C 619 S State St, Clarksdale, MS 38614-6319 Ph: (662) 812-1229

Reviews and Comments

Nurse Practitioner Nurses in Clarksdale, MS

Margaret Chandler Lewis, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2245 N State St, Clarksdale, MS 38614 Phone: 662-627-4131 Fax: 662-627-4131
Mrs. Regina Denise Groner, NURSE PRACTITIONER Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 619 S State St, Clarksdale, MS 38614 Phone: 662-966-1012
Gwenevere Chew, CFNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 340 Desoto Avenue Ext, Clarksdale, MS 38614 Phone: 662-741-2151 Fax: 662-741-2700
Anna Jones, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 220 Sunflower Ave, Clarksdale, MS 38614 Phone: 662-351-2035 Fax: 662-351-2045
Lashonda Lashay Bradley, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1967 Hospital Dr, Clarksdale, MS 38614 Phone: 662-624-5481 Fax: 662-621-1499
Dr. Carleen Thompson, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1402 Miller Dr, Clarksdale, MS 38614 Phone: 662-627-8694
Chandra Patrice Holmes, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 619 S State St, Clarksdale, MS 38614 Phone: 662-966-1012

Cody Renaldo Gullick, FNP-C - Medicare Nurse Practitioner in Clarksdale, MS