Connor McCullough, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT030709 Issued in PA

Practice address

451 Baltimore Pike
Springfield, PA 19064-3810

Phone

(610) 541-7874

NPI assigned

May 31, 2022

Sex

Male

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

Enrolled in PA

Enrollment records 1

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 and National Provider Directory roles.

• Full Range Health Services, LLC

  • Physical Therapist
  • Exton, PA
  • NPI 1982029377
  Medicare reassignment NPD
• Advanced Orthopaedic Centers PA

  • Orthopaedic Surgery Physician
  • Woodbury, NJ
  • NPI 1275574667

  Physical Therapist

  NPD (past)
• Rehabclinics Galaxy Inc

  • Physical Therapy Clinic/Center
  • Greenfield, WI
  • NPI 1447250006
  NPD (past)

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1063151983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 TASKER AVE",
            "city": "FOLSOM",
            "state": "PA",
            "postal_code": "190331420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 BALTIMORE PIKE",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643810",
            "telephone_number": "610-541-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "CONNOR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "TPT023528",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT030709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Maylie
• Joanna Mazepink, RN
• Jeremy McCallister, AUD
• Maura Patricia McCarthy, DO
• Maureen Frances McClatchy
• Mary Jane McDevitt, RN,MSN,CRNP,CDE
• Jennifer Stephanie McGarry, FNP-C
• Christine McGinnis, PSY.D.
• Fred B McKinney, PH.D.
• Sharon Ann Meehan, LCSW

• Physical Therapist in Springfield, PA
• Providers in Springfield, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.