Devan McCulloch

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070070147 Issued in IL

Practice address

201 Lincoln Statue Dr
Dixon, IL 61021-2000

Phone

(815) 284-1700

NPI assigned

Jan 13, 2015

Sex

Female

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

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ortho Rehab Specialists PLLCGroup PAC ID 8527492354, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ortho Rehab Specialists PLLC

  • Physical Therapist
  • Rockford, IL
  • NPI 1891330882
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1205225323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10713 E LINDENWOOD RD",
            "city": "CHANA",
            "state": "IL",
            "postal_code": "610159673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LINCOLN STATUE DR",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610212000",
            "telephone_number": "815-284-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "DEVAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070070147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Mayer
• Abigail Mayers-Brown, RBT
• Charlotte Lee McCoy
• Emma McCoy
• Patrick Michael McCue, MHP
• Devin McElhinney
• Jodi L. McFalls
• Brett Austin McGowan, M.D.
• Medical Products Group Inc
• Medical Products Group, LLC

• Physical Therapist in Dixon, IL
• Providers in Dixon, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.