Active NPI
Mary Louise McCullough, DPT
- Physical Therapist
- Beaufort, SC
National Provider Identifier
1699604355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13351
- Practice address
- 2121 Boundary St Ste 200
Beaufort, SC 29902-6812 - Phone
- (843) 524-4778
- Fax
- (843) 524-4779
- NPI assigned
- May 18, 2026
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 13351 | SC | Primary |
Addresses
Primary practice location
2121 Boundary St Ste 200
Beaufort, SC 29902-6812
Mailing address
2121 Boundary St Ste 200
Beaufort, SC 29902-6812
Phone (843) 524-4778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260601002986 | SC | Practitioner - Physical Therapist in Private Practice | 7517437460 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2026
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2121 Boundary St
Suite 200
Beaufort, SC 29902-6812
Phone (843) 524-4778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13351 | SC | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gravity Physical Therapy, Inc. | Current | Accepting new patients |
Locations
2121 Boundary St
Ste 200
Beaufort, SC 29902
Phone (843) 524-4778
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1699604355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 BOUNDARY ST STE 200",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299026812",
"telephone_number": "843-524-4778",
"fax_number": "843-524-4779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 BOUNDARY ST STE 200",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299026812",
"telephone_number": "843-524-4778",
"fax_number": "843-524-4779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "MARY",
"middle_name": "LOUISE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-18",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "13351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beaufort, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.