Edward Francis McCullough, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5731 Issued in OR

Practice address

2625 Martin Way E Ste a
Olympia, WA 98506-4900

Phone

(541) 779-8338

NPI assigned

Jan 31, 2008

Last updated

Jul 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• MC3 Enterprises LLC

  • Chiropractor
  • Olympia, WA
  • NPI 1740804830
  Medicare reassignment NPD
• Northwest Life Chiropractic

  • Chiropractor
  • Medford, OR
  • NPI 1184121147
  NPD Authorized official
• Gustav E Schefstrom

  dba Rogue Valley Chiropractic Clinic

  • Chiropractor
  • Medford, OR
  • NPI 1790968220
  NPD (past)

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1558548677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 SUMMIT LAKE SHORE RD NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985029437",
            "telephone_number": "360-810-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 MARTIN WAY E STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985064900",
            "telephone_number": "541-779-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "EDWARD",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-31",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2296",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4367-12",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "3672603",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Michael McConnell, DC
• Cecilia McCormick
• Nicole R McCowan, MASSAGE PRACTITIONER
• Grace Gabrielle McCown
• Carol Jean McCulloch, RPH
• Lisa McCullough, D.C.
• Madelaine Cathleen McCullough, PA-C
• Sarah Rachel McCullough, MA60135663
• Deana Marie McCusker
• Crystal Shanell McDaneld

• Chiropractor in Olympia, WA
• Providers in Olympia, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.