Active NPI
Haley Marie McCullough, P.A.-C
- Medical Physician Assistant
- Delta, CO
National Provider Identifier
1609331479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA.0006117
- Practice address
- 296 Stafford LN
Delta, CO 81416-2273 - Phone
- (970) 874-5777
- Fax
- (970) 874-1631
- NPI assigned
- Feb 6, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA.0006117 | CO | Primary |
Addresses
Primary practice location
296 Stafford LN
Delta, CO 81416-2273
Mailing address
PO Box 10100
Delta, CO 81416-0008
Phone (970) 874-5777
Other practice location 1
1450 Burgess St
Delta, CO 81416-2849
Phone (970) 874-7668
Other practice location 2
230 Hotchkiss Ave
Hotchkiss, CO 81419-7608
Phone (970) 872-1400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000250847 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
296 Stafford LN
Delta, CO 81416-2243
Phone (970) 399-2635
Hospital & facility affiliations
- Hopewest Grand Junction
- Delta County Memorial Hospital
- Montrose Regional Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.0006117 | CO | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delta County Memorial Hospital | Current | Accepting new patients | |
| Delta County Memorial Hospital | Family Medicine | Past | Accepting new patients |
Locations
1501 E 3rd St
Delta, CO 81416
Phone (970) 874-2470
Interoperability endpoints
- haley.carlton.1@12539.direct.athenahealth.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rural Acute Care Hospital
- Delta, CO
- NPI 1417935446
-
- Multi-Specialty Clinic/Center
- Delta, CO
- NPI 1467019422
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Delta, CO
- NPI 1417935446
-
- Community Based Hospice Care Agency
- Delta, CO
- NPI 1326646886
-
- Community Based Hospice Care Agency
- Grand Junction, CO
- NPI 1427041227
-
- Community Based Hospice Care Agency
- Montrose, CO
- NPI 1811595374
-
- Community Based Hospice Care Agency
- Grand Junction, CO
- NPI 1851990980
-
- General Acute Care Hospital
- Montrose, CO
- NPI 1205822186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780617600000",
"number": "1609331479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10100",
"city": "DELTA",
"state": "CO",
"postal_code": "814160008",
"telephone_number": "970-874-5777",
"fax_number": "970-874-1631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "296 STAFFORD LN",
"city": "DELTA",
"state": "CO",
"postal_code": "814162273",
"telephone_number": "970-874-5777",
"fax_number": "970-874-1631"
}
],
"practiceLocations": [
{
"address_1": "1450 Burgess St",
"address_purpose": "LOCATION",
"city": "Delta",
"state": "CO",
"postal_code": "814162849",
"country_code": "US",
"telephone_number": "970-874-7668",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "230 Hotchkiss Ave",
"address_purpose": "LOCATION",
"city": "Hotchkiss",
"state": "CO",
"postal_code": "814197608",
"country_code": "US",
"telephone_number": "970-872-1400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "HALEY",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-06",
"last_updated": "2026-06-05",
"certification_date": "2026-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "PA.0006117",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000250847",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Delta, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.