MULLISSA CHILDRESS CCM MEDICAL SERVICES
NPI 1073033528
Nurse Practitioner - Family in Las Vegas, NV

Q: What is Mullissa Childress Ccm Medical Services's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since June 26, 2017

222 S RAINBOW BLVD STE 115, LAS VEGAS, NV 89145(702) 406-4125 Get Directions Write a Review

NPPES record last updated: April 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 10, 2025, Aug 21, 2024, May 13, 2024 and 3 more (6 updates tracked since 2017).

On this page

About Mullissa Childress Ccm Medical Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MULLISSA CHILDRESS CCM MEDICAL SERVICES (NPI 1073033528), doing business as Ccm Medical Services, is a healthcare organization registered as a family in Las Vegas, Nevada and active in the NPI registry since June 2017. The organization lists Mullissa Michelle Childress, Nurse Practitioner Provider, as its authorized official.

NPPES Registry Identity

NPI1073033528

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameMULLISSA CHILDRESS CCM MEDICAL SERVICES

Location Address222 S RAINBOW BLVD STE 115Las Vegas, NV 89145-5126

Mailing Address5300 Bright Sun CtLas Vegas, NV 89130 · (614) 496-8420 · Fax (702) 745-0452

Phone(702) 406-4125

Organization SubpartNo

Authorized OfficialMullissa Michelle ChildressNurse Practitioner Provider · (702) 406-4125

Enumeration DateJune 26, 2017

Last NPPES UpdateApril 10, 20256 updates tracked since enumeration

NPPES CertifiedApril 10, 2025

✔ NPI 1073033528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X

Also ListedGeneral PracticeTaxonomy 208D00000X

222 S RAINBOW BLVD STE 115, Las Vegas, NV 89145

Open in Google Maps ↗

Other Names 1

Doing Business AsCcm Medical Services

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MDHI MEDICAL SERVICES CORPORATION

Physiological Laboratory

222 S RAINBOW BLVD STE 115
LAS VEGAS, NV 89145

Clark County (720) 727-8160

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mullissa Childress Ccm Medical Services's NPI number?

The NPI number for Mullissa Childress Ccm Medical Services is 1073033528. It was assigned to this organization in the NPPES registry on June 26, 2017. The provider is doing business as CCM Medical Services.

Where is Mullissa Childress Ccm Medical Services located?

Mullissa Childress Ccm Medical Services is located at 222 S Rainbow Blvd Ste 115, Las Vegas, NV 89145. The listed phone number is (702) 406-4125.

What is Mullissa Childress Ccm Medical Services's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Mullissa Childress Ccm Medical Services was last updated on April 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.