Kelly McCullough

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

954 N County Road 250 W
Brazil, IN 47834-7495

Phone

(812) 243-5925

NPI assigned

Jan 30, 2015

Last updated

Jan 30, 2015By 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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1063802981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 N COUNTY ROAD 250 W",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "478347495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 N COUNTY ROAD 250 W",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "478347495",
            "telephone_number": "812-243-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Mathers
• George Frederick Maurer, RPH,CCN,NDM
• Kelly Michelle Maurer, P.T.
• Maurer's Apothecary (Maurer's Wellness Center)
• Elizabeth A. McCalister, M.D.
• Maranda R McKinney, FNP
• Camillo M Mendoza, MD
• Mid America Clinical Laboratories, LLC
• Lois Lynn Moss, MD
• National Drug Store Inc (Lynn's Pharmacy)

• Student in an Organized Health Care Education/Training Program in Brazil, IN
• Providers in Brazil, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.