Patrick McCullough

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

46TA09019000 Issued in NJ

Practice address

895 Westfield Rd
Moorestown, NJ 08057-2123

Phone

(856) 914-0444

NPI assigned

May 24, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1400889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400889600000",
    "number": "1396157392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 GARFIELD AVE",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080772225",
            "telephone_number": "856-829-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 WESTFIELD RD",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572123",
            "telephone_number": "856-914-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-24",
        "last_updated": "2014-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NJ",
            "license": "46TA09019000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah McAndrew
• Joseph W McBride Jr., D.C.
• Catherine Kelly McCrane, MA, LPC, NCC
• Jamie McCulloh-Martin, PT
• Elaine J McCullough, LCSW
• Kate Marie McDonald, CEP
• Danielle McFarland, BCBA
• David McGain
• Meghan McGoldrick
• Albert Taylor McHugh, MD

• Community Health Worker in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Community Health Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.