Mildred Fleming McCully, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

19766 Issued in SC

Practice address

103 Stuard St
Gaffney, SC 29341-1263

Phone

(864) 514-1080

Fax

(864) 560-1090

NPI assigned

Jan 25, 2007

Last updated

Jun 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lincoln Pediatrics Clinic,PA

  • Specialist
  • Lincolnton, NC
  • NPI 1477510659
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1841345915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277723",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847723",
            "telephone_number": "864-560-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 STUARD ST",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293411263",
            "telephone_number": "864-514-1080",
            "fax_number": "864-560-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLY",
        "first_name": "MILDRED",
        "middle_name": "FLEMING",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "300071",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "19766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCC6123365",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCC612J577",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3570",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCC6125019",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCC612H895",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Margie Lee McCain, APRN
• Anna McCraw
• Kayla Bolf McCraw, RN, BSN
• Margaret McCraw
• Madisyn McCullough
• Troy D. McCurry, APRN
• Laurynn McDaniel
• Michael Shannon McGuinn, FNP
• Joseph Mark McKowen, PT
• Grace McSwain

• Pediatric Nurse Practitioner in Gaffney, SC
• Providers in Gaffney, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.