Active NPI
Ellen Maccullough, RN
- School Registered Nurse
- Forest Hills, NY
National Provider Identifier
1548699663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 3331171
- Practice address
- 10225 67TH Dr
Apt. # 4L
Forest Hills, NY 11375-2860 - Phone
- (347) 886-7396
- NPI assigned
- Nov 8, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 3331171 | NY | Primary |
Addresses
Primary practice location
10225 67TH Dr
Apt. # 4L
Forest Hills, NY 11375-2860
Mailing address
10225 67TH Dr
Apt. # 4L
Forest Hills, NY 11375-2860
Phone (347) 886-7396
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3331171 | NY | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383868800000",
"number": "1548699663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10225 67TH DR",
"address_2": "APT. # 4L",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113752860",
"telephone_number": "347-886-7396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10225 67TH DR",
"address_2": "APT. # 4L",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113752860",
"telephone_number": "347-886-7396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACCULLOUGH",
"first_name": "ELLEN",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-08",
"last_updated": "2013-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "NY",
"license": "3331171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.