James Michael McCullock, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

88704 Issued in CA

Practice address

4494 39TH St
San Diego, CA 92116-4677

Phone

(619) 902-2591

NPI assigned

Apr 7, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1598407819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4494 39TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164677",
            "telephone_number": "619-902-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4494 39TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164677",
            "telephone_number": "619-902-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCK",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-07",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "88704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://drive.google.com/drive/u/1/folders/1EYQUMZdPRgEmrXBcglxL_BTTYAK_6-Vo",
            "affiliation": "N",
            "endpointDescription": "Secure Files",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Text",
            "address_1": "4494 39th St",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921164677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph M McCullaugh, PH. D.
• David James McCulley, M.D.
• Lisa McCulloch
• Molly McCulloch
• Robert Corey McCulloch, PH.D.
• Alexis Makiko McCullough, OD
• Amanda McCullough
• Deirdre Maureen McCullough, M.D.
• Jocelyn Colleen McCullough, M.A.
• Lynsi McCullough

• Massage Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.