Craig A McCullough, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME59666 Issued in FL

Practice address

333 Tamiami TRL S
Suite 101
Venice, FL 34285-2402

Phone

(941) 488-7716

Fax

(941) 488-0511

NPI assigned

Aug 13, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1265444665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 TAMIAMI TRL S",
            "address_2": "SUITE 101",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852402",
            "telephone_number": "941-488-7716",
            "fax_number": "941-488-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 TAMIAMI TRL S",
            "address_2": "SUITE 101",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852402",
            "telephone_number": "941-488-7716",
            "fax_number": "941-488-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "CRAIG",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME59666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055156200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11954",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon McCampbell, PTA
• Brantley McCarty
• Danelle McCaw
• Michael Thomas McCormick, DPM
• Suzanne J McCormick, PHARMD
• Heather C McCullough, MD
• Dennis Matthew McDonagh, COTA
• Travis McDonald, DPT
• Donald Alvin McEachern, M.D.
• Paul Matthew McElligott, D.C.

• Internal Medicine Physician in Venice, FL
• Providers in Venice, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.