Christopher Yacullo

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1115710

Practice address

2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-0001

Phone

(910) 907-8922

Fax

(910) 907-6069

NPI assigned

Jan 23, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1154744316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACULLO",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-23",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": "1115710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Witt, LCSW
• Thomas Wojak, PA-C
• Samantha Marie Wolfe
• Justin Trevor Woodson, MD
• Ian Tyda Wrigglesworth, PA-C
• Jennifer Rene Yager, RN
• Michael Maurice Ybarra, PA-C
• Tiffany Youngberg, CMHC, LPC, LCPC
• Tracie Zacharek, LPC
• Katherine Marie Zamperini, MD

• Medical Physician Assistant in Fort Liberty, NC
• Providers in Fort Liberty, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.