NPIMap

Individual provider Active NPI

Thomas McCullough

  • Internal Medicine Physician
  • Aiken, SC
National Provider Identifier
1093980757
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
TL34041 Issued in SC
Practice address
410 University Pkwy Ste 2500
Aiken, SC 29801-6830
Phone
(803) 648-7888
Fax
(803) 648-3302
NPI assigned
Apr 24, 2008
Last updated
Aug 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TL34041 SC Primary
Internal Medicine Physician 207R00000X 148953 NC

Addresses

Primary practice location

410 University Pkwy Ste 2500
Aiken, SC 29801-6830

Mailing address

PO Box 215
Aiken, SC 29802-0215
Phone (803) 648-7888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120103000428 SC Practitioner - Internal Medicine 3173799756 Reassigns benefits to 2 organizations
Practice locations: Aiken, SC

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Carolina School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aiken Internal Med PAGroup PAC ID 6608863782, 2 clinicians

Practice addresses (Care Compare)

302 University Pkwy
Aiken, SC 29801-6302
Phone (803) 641-5000

410 University Pkwy
Suite 2500
Aiken, SC 29801-6830
Phone (803) 648-7888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
148953NCMDInternal Medicine Physician
TL34041SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Regional Medical Centers LLC Current Accepting new patients
Aiken Regional Medical Centers LLC CurrentSince Apr 22, 2015 Accepting new patients
Aiken Regional Medical Centers, LLC. CurrentSince Apr 22, 2015 Accepting new patients
Aiken Internal Med PA Internal Medicine CurrentSince Nov 15, 2011 Accepting new patients
Pruitthealth - Aiken, LLC PastSince Oct 10, 2025 Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

410 University Pkwy
Ste 2500
Aiken, SC 29801
Phone (803) 648-7888

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pruitthealth - AikenAiken, SC, CCN 425145 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2021
Oct 10, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1093980757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298020215",
            "telephone_number": "803-648-7888",
            "fax_number": "803-648-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 UNIVERSITY PKWY STE 2500",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016830",
            "telephone_number": "803-648-7888",
            "fax_number": "803-648-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "TL34041",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "148953",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.