Colleen McCully

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00588500 Issued in NJ

Practice address

2300 New Rd
Northfield, NJ 08225-1466

Phone

(609) 204-4849

NPI assigned

Aug 30, 2021

Last updated

Aug 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Fitness, LLCGroup PAC ID 4385878362, 57 clinicians

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.

• Spectrum Fitness, LLC

  • Specialist
  • Northfield, NJ
  • NPI 1053750588

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Holistic Approach Physiotherapy Intervention, LLC

  • Physical Therapist
  • Northfield, NJ
  • NPI 1588443360
  NPD
• Spectrum Rehabilitation LLC

  • Physical Therapist
  • Northfield, NJ
  • NPI 1295822401
  NPD

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1609543396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W YORKSHIRE AVE",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082252152",
            "telephone_number": "609-703-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 NEW RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251466",
            "telephone_number": "609-204-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLY",
        "first_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00588500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Leigh Mattiace
• Maximum Function, LLC
• Holly McBrearty
• Loretta M McCormick, LPC, LCADC
• Melissa McCue
• Maeve McFadden, ATC
• Wendy McKensie, LPC
• John Joseph McLernon
• Addison Marie Meeker, OTR/L
• Diane Melano, NTC

• Physical Therapist in Northfield, NJ
• Providers in Northfield, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.