Active NPI
Patrick McCullough Dom, M.D.
- Anesthesiology Physician
- Salisbury, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- D0062873
- Practice address
- 100 E Carroll St
Salisbury, MD 21801-5422 - Phone
- (410) 543-7375
- NPI assigned
- Nov 16, 2005
- Last updated
- Sep 28, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | D0062873 | MD | Primary |
Addresses
Primary practice location
100 E Carroll St
Salisbury, MD 21801-5422
Mailing address
1325 Mount Hermon Rd
Suite 14B
Salisbury, MD 21804-5259
Phone (410) 742-4401
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00222914 | Other | MD | RAILROAD MEDICARE |
| 407816100 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0062873 | MD | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davis Memorial Hospital | Current | Accepting new patients | |
| Medstream Anesthesia PLLC | Anesthesiology | Current | Accepting new patients |
| Davis Memorial Hospital | Current | Accepting new patients | |
| Northstar Anesthesia of West Virginia, PLLC | Anesthesiology | Current | Accepting new patients |
| Associated Anesthesiology Practice P.a. | Anesthesiology | Past | Accepting new patients |
Locations
1000 Medical Center Dr
Hardeeville, SC 29927
Phone (843) 784-8138
2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570
812 Gorman Ave
Elkins, WV 26241
Phone (304) 636-3300
1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960
Interoperability endpoints
- pdom389423@direct.wvuhsdirect.com
Organizations & group practices 5
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.
-
dba Davis Medical Center
- General Acute Care Hospital
- Elkins, WV
- NPI 1619964806
-
dba Health Center Pharmacy
- Community/Retail Pharmacy
- Elkins, WV
- NPI 1700663226
-
- Anesthesiology Physician
- Salisbury, MD
- NPI 1902887425
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mon Health Marion
- General Acute Care Hospital
- White Hall, WV
- NPI 1508441304
-
dba Mon Health Medical Center
- Specialist
- Morgantown, WV
- NPI 1447673223
Hospital
-
dba Mon Health Medical Center
- General Acute Care Hospital
- Morgantown, WV
- NPI 1659489631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190937600000",
"number": "1568444552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 MOUNT HERMON RD",
"address_2": "SUITE 14B",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218045259",
"telephone_number": "410-742-4401",
"fax_number": "410-742-4798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E CARROLL ST",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218015422",
"telephone_number": "410-543-7375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOM",
"first_name": "PATRICK",
"middle_name": "MCCULLOUGH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2007-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MD",
"license": "D0062873",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00222914",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "407816100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.