Lyan Love G. McCullough, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95028990 Issued in CA

Practice address

502 Euclid Ave Ste 200
National City, CA 91950-2984

Phone

(619) 434-4019

Fax

(619) 434-4023

NPI assigned

Jan 9, 2013

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

Other names 1

• Lyan McCullough Professional name

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

Henry a Richardson MD a Medical CorporationGroup PAC ID 0749537801, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Active Health Services Home health agency, San Diego, CA, CCN 059672
• Good Samaritan Home Health Inc Home health agency, National City, CA, CCN 757272
• A Better Solution in Home Care Home health agency, San Diego, CA, CCN 053116

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lyan.mccullough@opsam.eclinicaldirectplus.com

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.

• Henry a. Richardson, MD a Medical Corporation

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Chula Vista, CA
  • NPI 1447768197
  Medicare reassignment Care Compare group NPD
• Brenton D. Wynn, MD Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • National City, CA
  • NPI 1598953960
  Medicare reassignment NPD
• Guardian Biologics LLC

  • Specialist
  • Mount Juliet, TN
  • NPI 1033890876

  CA

  Medicare reassignment NPD
• Innovative Pain Management Medical Group

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • National City, CA
  • NPI 1902330285
  NPD (past)
• Operation Samahan, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1194616268
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Comfort and Thrive Home Health Corporation

  • Home Health Agency
  • San Diego, CA
  • NPI 1588053177
  Care Compare affiliation
• Good Samaritan Home Health Care, Inc.

  • Home Health Agency
  • National City, CA
  • NPI 1669082350
  Care Compare affiliation
• Medi-Art Home Health Care, Inc.

  • Home Health Agency
  • San Diego, CA
  • NPI 1598174104
  Care Compare affiliation

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1063759181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 STEARNS WHARF RD",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919133566",
            "telephone_number": "619-259-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 200",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502984",
            "telephone_number": "619-434-4019",
            "fax_number": "619-434-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "LYAN LOVE",
        "middle_name": "G.",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2024-02-07",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "779235",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYAN",
            "last_name": "MCCULLOUGH",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Leah McCarthy, MOT, OTR/L
• Gary L McClanahan, DDS
• Jonathan McClendon
• Madisyn McCormick
• Anarosela McCullough, SLP
• Tyler McDonald
• Meded Consultants
• Natalie Jo Medina, M.D.
• Abby Meehan, MS OTR/L
• Ernest Ritualo Mejia, P.A.

• Family Nurse Practitioner in National City, CA
• Providers in National City, 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 Feb 7, 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.