Michael McCullough I

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A63113 Issued in CA

Practice address

2823 Fresno St
Fresno, CA 93721-1324

Phone

(559) 459-6000

NPI assigned

Aug 24, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1255448122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 OAK CREEK DR",
            "address_2": "# 308",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-459-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "MICHAEL",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A63113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A631130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa McCracken
• Makayla McCrae
• Victor Wayne McCray, M.D.
• John Robert McCreary, MD
• Julia Kellee McCreary, PSYD
• Angel McCurn
• Andrea McDaniel, LMFT
• Lance Scott McDaniel, CADTP 7377
• Johnnie McDonald
• Kayla McDonald

• Emergency Medicine Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.