Stephen McCullough, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2018020974 Issued in MO

Practice address

2035 Zumbehl Rd
Saint Charles, MO 63303-2723

Phone

(636) 946-1176

NPI assigned

Jun 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2018

Medicare assignment

May accept Medicare assignment

Group practices

McCullough Optometry Associates PCGroup PAC ID 6709868664, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• McCullough Optometry Associates, P.C.

  • Optometrist
  • Saint Charles, MO
  • NPI 1265508006

  MO

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1720572001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 ZUMBEHL RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 ZUMBEHL RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032723",
            "telephone_number": "636-946-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2018020974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Ann McConnaha, PT
• Amy Theresa McCory, ANP
• Joann Lee McCracken, TH.D., L.P.C.
• McCullough Optometry Associates, P.C.
• Angela Christine McCullough, P.T.
• Hannah Elizabeth McDermott, PHARMD
• Melanie McDole, MA. LPC
• Beth Allyson McDonald, M.S., CCC-SLP
• Jessica McDonald
• Angela Kristeen McDonnell, FNP-BC

• All providers in Saint Charles, MO
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.