Michael Allen McCullough, PHD, NP-BC, AP-RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN057553NP Issued in GA

Practice address

101 Yorktown Dr
Fayetteville, GA 30214-1578

Phone

(770) 460-4075

NPI assigned

Sep 25, 2012

Last updated

Sep 25, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coweta Emergency Group LLC

  • Emergency Medicine Physician
  • Newnan, GA
  • NPI 1245556588
  Medicare reassignment NPD
• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  NPD (past)

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1316298870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 YORKTOWN DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141578",
            "telephone_number": "770-460-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 YORKTOWN DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141578",
            "telephone_number": "770-460-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "credential": "PHD, NP-BC, AP-RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN057553NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie A McCullar, APRN
• Garry Oneil McCulloch, M.D.
• Megan Marie McCullough Vieira, NP
• Haley McCullough, RBT
• Lauren Elizabeth McCullough, DPT
• Kaleya McDaniel, RBT
• Karen Whatley McDonald, MSN, FNP-C
• Katheryn D. McDonell, CNS-BC
• Arthur Randall McDowell Jr., MD
• Brittney D McGhee, OT

• Family Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.