Kathleen Rose McCullough, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07415 Issued in NC

Practice address

4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211-4369

Phone

(704) 355-5100

NPI assigned

Dec 10, 2012

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
• Atrium Health Pineville Hospital, Charlotte, NC, CCN 340098

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as apm

Quality

81.63

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmccullough222125@carolinashealthcaresystem.direct-ci.com

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.

• Carolinas Physicians Network Inc

  dba Atrium Health Musculoskeletal Institute Orthopedics & Sports Medici

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1437607686
  Medicare reassignment Care Compare group
• The Charlotte-Mecklenburg Hospital Authority

  dba Levine Cancer Institute

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment NPD
• Carolinas Medical Center

  dba Atrium Health Levine Children's Gastroenterology

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333
  Medicare reassignment
• Carolinas Medical Center

  dba CMC Psychiatry and Behavioral Health

  • Adult Health Nurse Practitioner
  • Charlotte, NC
  • NPI 1457699605
  NPD
• Carolinas Medical Center

  dba Atrium Health Pharmacy Kenilworth

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  NPD
• Carolinas Physicians Network Inc

  dba Atrium Health Diabetes Prevention

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network Inc

  dba Atrium Health Diabetes & Nutrition Care

  • Registered Dietitian
  • Huntersville, NC
  • NPI 1518405257
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Endocrinology - Monroe

  • Endocrinology, Diabetes & Metabolism Physician
  • Monroe, NC
  • NPI 1801302492
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Pineville Rehabilitation Hospital

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carolinas Medical Center

  dba Atrium Health Behavioral Health

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1295789907
  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Mercy

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1376985135
  Care Compare affiliation
• Carolinas Medical Center

  dba Levine Children's Hospital Pediatrics

  • Children's Rehabilitation Hospital
  • Charlotte, NC
  • NPI 1699829887
  Care Compare affiliation
• Carolinas Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1720029705

  Hospital

  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Laboratory

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1811005150

  Hospital

  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Pineville

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1417432840
  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Pineville Rehabilitation Hospital

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  Care Compare affiliation

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1518202068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 CAMERON VALLEY PKWY",
            "address_2": "STE 4100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114369",
            "telephone_number": "704-355-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1585 Forney Creek Pkwy",
            "address_2": "Ste 2350",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "NC",
            "postal_code": "280379514",
            "country_code": "US",
            "telephone_number": "980-212-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-302-9462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_2": "Ste 330",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-468-8877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "441 McAlister Rd",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924126",
            "country_code": "US",
            "telephone_number": "980-212-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "KATHLEEN",
        "middle_name": "ROSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmccullough222125@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 4100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282114369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cramer Austin McCullen, MD
• Harlan A McCulloch, MD
• McCullough Center for Community Services
• Batonya McCullough
• Katherine A a McCullough, PA
• Tiffany Vilese McCullough, LMFTA
• Isiah McCullum
• Eleanor Mark McCurdy
• Kathleen Carter McCurdy, MSW, LCSW
• Lewis Hall McCurdy III, MD

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.