Individual provider Active NPI

Mary Louise McCullough, DPT

  • Physical Therapist
  • Beaufort, SC
National Provider Identifier
1699604355
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13351 Issued in SC
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

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
Gravity Physical Therapy IncGroup PAC ID 4789984832, 8 clinicians

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

LicenseStateTypeSpecialty
13351SCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gravity Physical Therapy, Inc. CurrentSince May 19, 2026 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.

Verify at the official NPI Registry.