Individual provider Active NPI

Kylie McCullough, PHARMD

  • Pharmacist
  • Great Falls, MT
National Provider Identifier
1528410545
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHA-PHA-LIC-102497 Issued in MT
Practice address
105 6TH St N
Great Falls, MT 59401-2531
Phone
(406) 791-7903
Fax
(406) 791-7998
NPI assigned
Jul 2, 2016
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26161 NC
Pharmacist 183500000X 0022122 CO
Pharmacist 183500000X PH60955618 WA
Pharmacist 183500000X PHA-PHA-LIC-102497 MT Primary

Addresses

Primary practice location

105 6TH St N
Great Falls, MT 59401-2531

Mailing address

601 1St Ave N
Great Falls, MT 59401-2510
Phone (406) 454-6973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0022122COMDMental Health Counselor
PHA-PHA-LIC-102497MTMDPharmacist
26161NCMDPharmacist
PH60955618WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care Center Incorporated CurrentSince Jun 16, 2024 Accepting new patients

Locations

105 6th St N
Great Falls, MT 59401
Phone (406) 791-7903

601 1st Ave N
Great Falls, MT 59401
Phone (406) 454-5074

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1467417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1528410545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 1ST AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594012510",
            "telephone_number": "406-454-6973",
            "fax_number": "406-791-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 6TH ST N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594012531",
            "telephone_number": "406-791-7903",
            "fax_number": "406-791-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "KYLIE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-02",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "26161",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "0022122",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60955618",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "PHA-PHA-LIC-102497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.