Individual provider Active NPI

Johanna Cullum, RN

  • Registered Nurse
  • Pittsburgh, PA
National Provider Identifier
1124775176
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN704119 Issued in PA
Practice address
320 E North Ave
Pittsburgh, PA 15212-4772
Phone
(412) 359-3131
NPI assigned
Mar 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN704119 PA Primary

Addresses

Primary practice location

320 E North Ave
Pittsburgh, PA 15212-4772

Mailing address

310 Kenyon Ave
Pittsburgh, PA 15229-1512
Phone (804) 615-6146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN704119PAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1124775176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 KENYON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152291512",
            "telephone_number": "804-615-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124772",
            "telephone_number": "412-359-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLUM",
        "first_name": "JOHANNA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN704119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.