Laurel Carrie McCulloh, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0061952 Issued in OK

Practice address

1011 14TH Ave NW
Ardmore, OK 73401-1828

Phone

(580) 220-6360

Fax

(580) 220-6708

NPI assigned

Feb 9, 2007

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

Other names 1

• Mrs. Laurel Hazlewood Foster Former name

Medicare fee-for-service enrollment

Enrolled in OK

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: laurel.mcculloh.1@21885.direct.athenahealth.com

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.

• Family Practice Associates

  • Family Medicine Physician
  • Ardmore, OK
  • NPI 1568576619
  Medicare reassignment NPD Authorized official
• Good Shepherd Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ardmore, OK
  • NPI 1285010413
  Medicare reassignment

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1487795613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 6TH AVE SW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734013530",
            "telephone_number": "580-220-6360",
            "fax_number": "580-220-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 14TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011828",
            "telephone_number": "580-220-6360",
            "fax_number": "580-220-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOH",
        "first_name": "LAUREL",
        "middle_name": "CARRIE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0061952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "FOSTER",
            "middle_name": "HAZLEWOOD",
            "prefix": "MRS.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kylie McClendon
• Gracey McCool
• Aaron Bryant McCoy, CRNA
• Kristi Rhea McCoy, M.ED.
• Amber Lynn McCullers, P.T.
• Thomas W McCulloh, DO
• Jennifer Leanne McCurry
• Jennifer Christina McDonald, PMHNP-BC
• Julia McDonald
• Melinda McDonald

• Family Nurse Practitioner in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.