Erin McCullough, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

286975 Issued in AZ

Practice address

4290 E Wild Elk TRL
Flagstaff, AZ 86004-7915

Phone

(928) 600-2474

NPI assigned

Feb 20, 2023

Sex

Female

Sole proprietor

Yes

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 AZ

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

Nurse Practitioner

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Haven of Flagstaff, LLC

  • Skilled Nursing Facility
  • Flagstaff, AZ
  • NPI 1588901839

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Haven of Sedona, LLC

  • Skilled Nursing Facility
  • Sedona, AZ
  • NPI 1073178976

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Ternion Physician Group, PLLC

  • Internal Medicine Physician
  • Anthem, AZ
  • NPI 1013466192

  Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1396443230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 E WILD ELK TRL",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860047915",
            "telephone_number": "928-600-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 E WILD ELK TRL",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860047915",
            "telephone_number": "928-600-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "ERIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "286975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marca McCallie, PHD, PSY
• James D McCallum, DPT
• John Thomas McCarthy, D.C.
• Anna E McClaugherty, M.A., LPC
• Nancy E McCleskey, M.S. COUNSELING
• Shannon McCutcheon, PHARMD
• Shawnee McDowell, LCSW
• William Michael McFadden, D.M.D.
• David L McGarey, M.D.
• Lee B McGarey, MD

• Nurse Practitioner in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.