Dr. Robert W. McCullough

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT000836 Issued in GA

Legal business name

DR. ROBERT W. MCCULLOUGH

Practice address

137 W Mill St
Jonesboro, GA 30236-3572

Phone

(770) 471-5037

NPI assigned

Feb 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Robert W. McCullough, O.D.NPI 1235214503

Title

Owner

Phone

(770) 471-5037

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert W. McCullough, O.D.

  • Optometrist
  • Jonesboro, GA
  • NPI 1235214503
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1639348162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 W MILL ST",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302363572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 W MILL ST",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302363572",
            "telephone_number": "770-471-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ROBERT W. MCCULLOUGH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-471-5037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.