Jeremy L. McCullough, PT, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305211812 Issued in VA

Practice address

15331 Creativity Dr # 960
Culpeper, VA 22701

Phone

(840) 317-0888

Fax

(540) 739-7475

NPI assigned

May 22, 2017

Sex

Male

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 NC, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidewater Physical Therapy LLCGroup PAC ID 6406759281, 225 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.16 of 100Reported as group

Quality

85.78

Promoting interoperability

99

Improvement activities

40

Cost

75.6

Medicare enrollment (NPD)

Enrolled

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.

• Tidewater Physical Therapy, LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1457389595
  Medicare reassignment Care Compare group NPD
• Activcare Physical Therapy, LLC

  dba Pivot Physical Therapy of Carolina

  • Clinic/Center
  • Raleigh, NC
  • NPI 1548409626

  Physical Therapist

  Medicare reassignment NPD
• Tidewater Physical Therapy, LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Roanoke, VA
  • NPI 1437664356
  NPD

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1043747983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15331 CREATIVITY DR # 960",
            "city": "CULPEPER",
            "state": "VA",
            "postal_code": "22701",
            "telephone_number": "840-317-0888",
            "fax_number": "540-739-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "JEREMY",
        "middle_name": "L.",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Stover May
• Brian McAlary
• Robert Wilson McCall, D.D.S.
• Kaitlin McCormac
• Christopher S. McCullough, M.D.
• Lisha McCurry, MA, LPC
• Amy P McElroy, MD
• Thomas McElroy
• Clare Collins McGhee
• Laura McGraw

• Physical Therapist in Culpeper, VA
• Providers in Culpeper, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.