Pamela R McCulloch, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01040377 Issued in IN

Practice address

5734 Coventry LN
Fort Wayne, IN 46804-7141

Phone

(260) 436-7875

NPI assigned

Oct 26, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Aas Indiana LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1831827021

  IN

  Medicare reassignment NPD
• U S Anesthesia Partners of Kentucky PSC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1144901042
  NPD (past)

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1124018668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 633260",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452633260",
            "telephone_number": "317-802-6303",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5734 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047141",
            "telephone_number": "260-436-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "PAMELA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01040377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003270000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robyn McCrammer
• Molly McCrory
• Joseph McCudden, ATC
• Deborah McCulloch, LCSW
• Laura E McCulloch, SLP
• Timothy McCullough, PT, DPT
• Melissa S. McDaniel, MA
• Gina McDonald, LMT
• James Patrick McDonald
• Margaret McDonald, PHARMD

• Anesthesiology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.