Nicole Elisabeth McCullough, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601009723 Issued in MI

Practice address

5296 Greenleaf Dr
Swartz Creek, MI 48473-1165

Phone

(586) 488-8610

NPI assigned

Feb 18, 2020

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

• Nicole Elisabeth Giddey Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Physician Group PCGroup PAC ID 0648277830, 11 clinicians

Clio Urgent Care PLLCGroup PAC ID 2062738446, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Clio Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Clio, MI
  • NPI 1114340171
  Medicare reassignment Care Compare group
• Legacy Physician Group, P.C.

  • Specialist
  • Lansing, MI
  • NPI 1801800719
  Medicare reassignment Care Compare group
• Amd Urgent Care Fenton

  • Urgent Care Clinic/Center
  • Fenton, MI
  • NPI 1437807807
  Medicare reassignment
• Amd Urgent Medical Care, PLLC

  • Urgent Care Clinic/Center
  • Clio, MI
  • NPI 1184968679
  Medicare reassignment
• Burton Urgent Care PLLC

  • General Practice Physician
  • Burton, MI
  • NPI 1790174076
  Medicare reassignment
• Holly Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Holly, MI
  • NPI 1831722719
  Medicare reassignment
• MD Enterprises PLLC

  • Urgent Care Clinic/Center
  • Davison, MI
  • NPI 1598217853
  Medicare reassignment
• Ppsmg Urgent Medical Care, PLLC

  • Urgent Care Clinic/Center
  • Swartz Creek, MI
  • NPI 1750704680
  Medicare reassignment
• Amd Primary Care, PLLC

  • Family Medicine Physician
  • Swartz Creek, MI
  • NPI 1568858504

  Single Specialty

  NPD (past)
• Lansing Urgent Care, PLC

  • Urgent Care Clinic/Center
  • Lansing, MI
  • NPI 1780987990
  NPD (past)

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1497388441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5296 GREENLEAF DR",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "484731165",
            "telephone_number": "586-488-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5296 GREENLEAF DR",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "484731165",
            "telephone_number": "586-488-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "NICOLE",
        "middle_name": "ELISABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601009723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GIDDEY",
            "middle_name": "ELISABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Martello
• Matthew William Marx, LMSW
• McBean Transitional Care, LLC.
• McBean Transitional Care, LLC.
• Eric Scott McBean
• Meaningful Conversations Counseling, PLLC
• Meijer, Inc.
• Michigan Community Services Inc
• Michigan Community Services, Inc
• Michigan Community Services, Inc

• Medical Physician Assistant in Swartz Creek, MI
• Providers in Swartz Creek, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.