Active NPI
Jason Christopher McCullough, D.C.
- Chiropractor
- Lincoln, NE
National Provider Identifier
1710078431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1397
- Practice address
- 2120 S 56TH St
Suite 101
Lincoln, NE 68506-2118 - Phone
- (402) 488-0288
- Fax
- (402) 488-0289
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1397 | NE | Primary |
Addresses
Primary practice location
2120 S 56TH St
Suite 101
Lincoln, NE 68506-2118
Mailing address
2120 S 56TH St
Suite 101
Lincoln, NE 68506-2118
Phone (402) 488-0288
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025432300 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1397 | NE | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Life Chiropractic, LLC | Chiropractor | Past | Accepting new patients |
| Van Engen Chiropractic Clinic PC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Chiropractor
- Lincoln, NE
- NPI 1477852697
-
- Chiropractor
- Lincoln, NE
- NPI 1316109135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459382400000",
"number": "1710078431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2120 S 56TH ST",
"address_2": "SUITE 101",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685062118",
"telephone_number": "402-488-0288",
"fax_number": "402-488-0289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 S 56TH ST",
"address_2": "SUITE 101",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685062118",
"telephone_number": "402-488-0288",
"fax_number": "402-488-0289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "JASON",
"middle_name": "CHRISTOPHER",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2016-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NE",
"license": "1397",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025432300",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.