CODY RENALDO GULLICK FNP-C
NPI 1205319530
Nurse Practitioner - Family in Clarksdale, MS
About Cody Renaldo Gullick Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CODY RENALDO GULLICK FNP-C (NPI 1205319530) is an individual family provider in Clarksdale, Mississippi, licensed in Mississippi (902905) and active in the NPI registry since September 2018. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Cody Renaldo Gullick Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Cody Gullick reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Clarksdale, MS 38614
- Reassigned Medicare billing, Mississippi enrollment
- 4 clinicians in this Medicare group
Sardis, MS 38666
- Reassigned Medicare billing, Mississippi enrollment
- Medicare enrollment name: Mettetal Family Medicince
- 6 clinicians in this Medicare group
Ripley, MS 38663
- Reassigned Medicare billing, Mississippi enrollment
- 463 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 38614 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Cody Gullick's NPI number?
The NPI number for Cody Gullick is 1205319530. It was assigned to this individual provider in the NPPES registry on September 12, 2018.
Where is Cody Gullick located?
Cody Gullick practices at 619 S State St, Clarksdale, MS 38614. The listed phone number is (662) 812-1229.
What is Cody Gullick's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Cody Gullick enrolled in Medicare?
Yes. Cody Gullick is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Cody Gullick's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Cody Gullick reassigns Medicare benefits to 3 organizations: Family First Clinic Of Clarksdale, PLLC (Clarksdale, MS), Cary N Mettetal (Sardis, MS) and Fast Pace Mississippi, PLLC (Ripley, MS). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Cody Gullick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Cody Gullick accept?
Health plans from Cigna Healthcare, Molina Healthcare, Oscar Health Plan, Inc., Oscar Insurance Company and UnitedHealthcare list Cody Gullick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Cody Gullick was last updated on September 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.
# Cody Renaldo Gullick, FNP-C · NPI 1205319530
Family physician in Clarksdale, Mississippi. Individual provider, active in the CMS NPPES registry since September 12, 2018.
## Identity
- **NPI:** 1205319530 (Entity type: Individual)
- **Enumerated:** September 12, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 902905 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 619 S STATE ST, Clarksdale, MS 38614-6319
- **Phone:** (662) 812-1229
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Family First Clinic Of Clarksdale, PLLC (NPI 1215206016, Clarksdale, MS); Cary N Mettetal (NPI 1083786727, Sardis, MS); Fast Pace Mississippi, PLLC (NPI 1447769559, Ripley, MS) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 12, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1205319530) · Data from the CMS NPPES public registry.