Active NPI
David R McCullough, RN
- Registered Nurse
- Albuquerque, NM
National Provider Identifier
1740433663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R30246
- Practice address
- 5901 Zuni Rd SE
Albuquerque, NM 87108-3073 - Phone
- (505) 383-1143
- Fax
- (585) 841-8977
- NPI assigned
- Oct 23, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R30246 | NM | Primary |
Addresses
Primary practice location
5901 Zuni Rd SE
Albuquerque, NM 87108-3073
Mailing address
PO Box 80810
Albuquerque, NM 87198-0810
Phone (505) 383-1143
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R30246 | Other | NM | SPECIAL HOSPITAL |
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R30246 | NM | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224720000000",
"number": "1740433663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 80810",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871980810",
"telephone_number": "505-383-1143",
"fax_number": "505-841-8977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 ZUNI RD SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871083073",
"telephone_number": "505-383-1143",
"fax_number": "585-841-8977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "DAVID",
"middle_name": "R",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-23",
"last_updated": "2008-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "R30246",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECIAL HOSPITAL",
"identifier": "R30246",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.