Letitia L McCully, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10004606 Issued in WA

Practice address

15812 E Indiana Ave
Spokane Valley, WA 99216-1875

Phone

(509) 444-8200

Fax

(509) 444-7806

NPI assigned

Jul 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, ID2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Association of SpokaneGroup PAC ID 9638063217, 222 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leticia.mccully.1@11411.direct.athenahealth.com

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.

• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Lewiston, ID
  • NPI 1235372707
  Medicare reassignment Care Compare group NPD
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1326005851
  Medicare reassignment NPD (past)
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1003994252
  NPD
• Community Health Association of Spokane

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
  • NPI 1679363592
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur D Alene, ID
  • NPI 1992798409
  Care Compare affiliation

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1780613547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N WASHINGTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010233",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15812 E INDIANA AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161875",
            "telephone_number": "509-444-8200",
            "fax_number": "509-444-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLY",
        "first_name": "LETITIA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8388431",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica McClaskey, CBT
• Bruce McClelland, M.D.
• Mackenzie M McCollam, SLP, M.S.
• Julia McComas, PHARMD
• Lee Erin McCormick, LMFT
• McDonald & Melkers, DDS
• Brandon Anthony McDonald, SUDPT
• James Clifford McDonald Jr.
• Ricki D'Ann McDonald, L.M.P.
• Sara McDougall, PTA

• Physician Assistant in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.