Mary Ellen K McCullough, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

35069652 Issued in OH

Practice address

5525 Marie Ave
Cincinnati, OH 45248-3200

Phone

(513) 751-2273

Fax

(513) 574-7062

NPI assigned

Aug 31, 2005

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1407840812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5053 WOOSTER RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452262326",
            "telephone_number": "513-751-2145",
            "fax_number": "513-751-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 MARIE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452483200",
            "telephone_number": "513-751-2273",
            "fax_number": "513-574-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "MARY ELLEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35069652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200499880",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64089188",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2048733",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheri McCullah Casbeer, PCC-S, LICDC
• Shawna L. McCullah, LPCC, CRC, CDMS
• Charles Anthony McCullough
• Kia McCullough, PMHNP
• Mary Beth McCullough, PH.D.
• Patrick J McCullough, M.D.
• Tyler Lenae McCullough
• Annie L McCune, AU.D
• Lisa McCune, RD, LDN
• Lakesha N McCurdy, LPN

• Hematology & Oncology Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Hematology & Oncology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.