Colleen McCullough, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2023168702 Issued in CA

Practice address

2950 International Blvd
Oakland, CA 94601-2228

Phone

(510) 535-4400

NPI assigned

Mar 10, 2023

Last updated

Mar 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Native American Health Center IncGroup PAC ID 4284697202, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Native American Health Center, Inc

  dba Native American Health Center

  • Federally Qualified Health Center (FQHC)
  • San Francisco, CA
  • NPI 1669642914
  Medicare reassignment Care Compare group NPD
• Native American Health Center, Inc

  dba Native American Health Center

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1477250504
  NPD
• Native American Health Center, Inc

  dba Native American Health Center

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1619147030
  NPD

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709424000000",
    "number": "1013618743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 VALLEY VIEW RD",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945631408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012228",
            "telephone_number": "510-535-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "COLLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-10",
        "last_updated": "2024-03-03",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "2023168702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Heather McCrea, AMFT
• Chante McCree, LMFT
• Robert McCreery, LCSW
• Rose Saoirse McCrudden-Welch
• Tanya McCullom
• Diane McCullough
• Elizabeth Ann McCullough
• Sarah Louise McCurry, RN
• Andrew Shawhan McDaniel, MD
• Keith McDaniel, M.D.

• Family Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.