Active NPI
Jessica Mathews McCullough, CRNP
- Acute Care Nurse Practitioner
- Mobile, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 1-106242
- Practice address
- 5955 Airport Blvd
Mobile, AL 36608 - Phone
- (251) 633-0573
- Fax
- (251) 633-7367
- NPI assigned
- Jul 7, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1-106242 | AL | |
| Acute Care Nurse Practitioner | 363LA2100X | 1-106242 | AL | Primary |
Addresses
Primary practice location
5955 Airport Blvd
Mobile, AL 36608
Mailing address
PO Box 7987
Mobile, AL 36670-0987
Phone (251) 633-0573
Other practice location 1
141 Tuscaloosa St
Mobile, AL 36607-3422
Phone (251) 433-3344
Other practice location 2
8725 County Road 64
Daphne, AL 36526-6061
Phone (251) 625-1370
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102I502393 | Other | AL | MEDICARE |
| 3092229 | Other | AL | UHC |
| 512-05477 | Other | AL | BCBS |
| 134189 | Medicaid | AL | |
| 222576 | Medicaid | AL | |
| 9582378 | Other | AL | AETNA |
| P00927530 | Other | AL | RR MEDICARE |
| Z12803 | Other | AL | VIVA HEALTH |
| 02482035 | Other | MS | MS MEDICAID |
| 510-49658 | Other | AL | BCBS |
| 214094 | Medicaid | AL | |
| 512-05479 | Other | AL | BCBS |
Other names 1
- Jessica Nicole Brock
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5955 Airport Blvd
Mobile, AL 36608-3135
Phone (251) 633-0573
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.38 of 100
- Promoting interoperability
- 96
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-106242 | AL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pulmonary Associates of Mobile PC | Current | Accepting new patients | |
| Pulmonary Associates of Mobile PC | Current | Accepting new patients | |
| Pulmonary Associates of Mobile PC | Past | Accepting new patients |
Locations
8725 County Road 64
Daphne, AL 36526
Phone (251) 625-1370
5955 Airport Blvd
Mobile, AL 36608
Phone (251) 633-0573
141 Tuscaloosa St
Mobile, AL 36607
Phone (251) 433-3344
6701 Airport Blvd
Ste B135
Mobile, AL 36608
Phone (251) 633-0573
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Critical Care Medicine (Internal Medicine) Physician
- Mobile, AL
- NPI 1194776278
-
- Pulmonary Disease Physician
- Mobile, AL
- NPI 1750366118
-
- Critical Care Medicine (Internal Medicine) Physician
- Mobile, AL
- NPI 1689624835
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mobile, AL
- NPI 1992489223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785456000000",
"number": "1053540450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7987",
"city": "MOBILE",
"state": "AL",
"postal_code": "366700987",
"telephone_number": "251-633-0573",
"fax_number": "251-633-7367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5955 AIRPORT BLVD",
"city": "MOBILE",
"state": "AL",
"postal_code": "36608",
"telephone_number": "251-633-0573",
"fax_number": "251-633-7367"
}
],
"practiceLocations": [
{
"address_1": "141 Tuscaloosa St",
"address_purpose": "LOCATION",
"city": "Mobile",
"state": "AL",
"postal_code": "366073422",
"country_code": "US",
"telephone_number": "251-433-3344",
"fax_number": "251-433-4052",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8725 County Road 64",
"address_purpose": "LOCATION",
"city": "Daphne",
"state": "AL",
"postal_code": "365266061",
"country_code": "US",
"telephone_number": "251-625-1370",
"fax_number": "251-625-1380",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "JESSICA",
"middle_name": "MATHEWS",
"name_prefix": "Mrs.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-07",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "1-106242",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AL",
"license": "1-106242",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "102I502393",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "3092229",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "512-05477",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "134189",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "222576",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9582378",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00927530",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA HEALTH",
"identifier": "Z12803",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS MEDICAID",
"identifier": "02482035",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "510-49658",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "214094",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "512-05479",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "BROCK",
"middle_name": "NICOLE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.