Jonathan McCully, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202010015NP-PP Issued in OR

Practice address

61822 Ten Barr Ranch Rd
Bend, OR 97701-9314

Phone

(541) 419-4054

NPI assigned

Jan 14, 2021

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 OR

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Precision Mental Performance LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, OR
  • NPI 1780166116
  Medicare reassignment NPD
• First Choice Psychiatry LLC

  • Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
  • Bend, OR
  • NPI 1023862711
  NPD Authorized official

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1396334264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61822 TEN BARR RANCH RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019314",
            "telephone_number": "541-419-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61822 TEN BARR RANCH RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019314",
            "telephone_number": "541-419-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLY",
        "first_name": "JONATHAN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-14",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202010015NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew McCown, M.S. CCC-SLP
• Angelina Renae McCoy, LMT
• Hayley Marie McCoy, OD
• Cassie McCraw, LAC, MSOM
• Caroline Bonafede McCulley, MD
• Tatum Lorea McDaniel
• Bailey A McDonald, PA-C
• Jan McDonald, LMT
• Maryanne Kelly McDonnell, LPC, LMFT
• Darby Jane McDonnieal, QMHA-1

• Psychiatric/Mental Health Nurse Practitioner in Bend, OR
• Providers in Bend, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.