Jennifer McCullough, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R857945 Issued in MS

Practice address

670 Leigh Dr
Columbus, MS 39705-3014

Phone

(662) 328-1012

NPI assigned

Oct 7, 2014

Last updated

Apr 7, 2015By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Children's Health Center of Columbus, Inc.

  dba Children's Health Center

  • Pediatrics Physician
  • Columbus, MS
  • NPI 1821185398

  Family

  NPD (past)

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1427451210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053014",
            "telephone_number": "662-328-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053014",
            "telephone_number": "662-328-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "JENNIFER",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R857945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01429835",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McClanahan and Vallette Surgical Associates, PLLC
• Jan T McClanahan, MD
• Eric E McClendon
• Keith McCoy, MD
• Cynthia McCrary, LPC
• Jaime Abbazia McDaniel, PHARMD
• Sarah E. McDaniel, PHARMD
• Madison McElroy, P-LPC
• Genika McGee, MS
• Jalenza McGee, NP

• Family Nurse Practitioner in Columbus, MS
• Providers in Columbus, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.