Mary Evelyn McCulley, CPNP-AC

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

448484 Issued in CA

Practice address

4650 W Sunset Blvd
Ms #66
Los Angeles, CA 90027-6062

Phone

(323) 361-4148

NPI assigned

Aug 6, 2010

Last updated

Aug 6, 2010By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1043525603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MS #66",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MS #66",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLEY",
        "first_name": "MARY",
        "middle_name": "EVELYN",
        "name_prefix": "Ms.",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "448484",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "CA",
            "license": "448484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Matthew McCrimmon
• Dawn McCrory, PT, DPT
• Raynique McCrory, ACNPC-AG
• Matthew Jordan McCubbin, MS, CF-SLP
• Brian McCulin
• Phillip Lee McCulley, LMFT
• Joan Helene McCulloch, MS
• Kalie McCulloch, DMD
• Patricia McCulloch
• Zhena McCullom

• Critical Care Pediatric Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Critical Care Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.