NPIMap

Individual provider Active NPI

James W McCullough, MD

  • Family Medicine Physician
  • Pueblo West, CO
National Provider Identifier
1679937353
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0067657 Issued in CO
Practice address
729 E Spaulding Ave
Pueblo West, CO 81007-3512
Phone
(719) 547-9119
NPI assigned
Apr 8, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X DR.0067657 CO
Family Medicine Physician 207Q00000X DR.0067657 CO Primary

Addresses

Primary practice location

729 E Spaulding Ave
Pueblo West, CO 81007-3512

Mailing address

PO Box 800022
Kansas City, MO 64180-0022
Phone (800) 953-0104

Other practice location 1

4112 Outlook Blvd Ste 303
Pueblo, CO 81008-1667
Phone (719) 557-8600

Other practice location 2

1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone (719) 776-8040

Other identifiers 1

IdentifierTypeStateIssuer
9000183241MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630003281 CO Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Hospitalist 2860786902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist, Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

729 E Spaulding Ave
PRPW PC Pueblo West
Pueblo West, CO 81007-3512
Phone (719) 547-9119

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Colorado Springs, CO, CCN 067449
  • Frontier Home Health LLC Home health agency, Pueblo, CO, CCN 067501
  • St Mary-Corwin Hospital Hospital, Pueblo, CO, CCN 060012
  • St Thomas More Hospital Hospital, Canon City, CO, CCN 061344

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Aug 1, 2023 Accepting new patients
Healogics Specialty Physicians of Colorado-Professional, LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Healogics Specialty Physicians of Colorado-Professional, LLC CurrentSince Jul 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Portercare Adventist Health System CurrentSince Aug 1, 2023 Accepting new patients
Portercare Adventist Health System CurrentSince Aug 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

100 Health Park Dr
Louisville, CO 80027
Phone (303) 673-1000

9399 Crown Crest Blvd
Ste 430
Parker, CO 80138
Phone (303) 269-2310

4112 Outlook Blvd
Ste 303
Pueblo, CO 81008
Phone (719) 557-8600

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

902 Lakeview Ave
Pueblo, CO 81004
Phone (719) 557-5855

4112 Outlook Blvd
Ste 250
Pueblo, CO 81008
Phone (719) 553-1066

729 E Spaulding Ave
Pueblo West, CO 81007
Phone (719) 285-2735

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 8

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1679937353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800022",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641800022",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 E SPAULDING AVE",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810073512",
            "telephone_number": "719-547-9119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4112 Outlook Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810081667",
            "country_code": "US",
            "telephone_number": "719-557-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1008 Minnequa Ave",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810043733",
            "country_code": "US",
            "telephone_number": "719-776-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "JAMES",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-08",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0067657",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0067657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000183241",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo West, CO

Sources for this page

Verify at the official NPI Registry.