Zaques J McCullough

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P016224 Issued in NC

Practice address

439 US Highway 158 W
Yanceyville, NC 27379-8304

Phone

(336) 694-9331

Fax

(336) 694-7511

NPI assigned

Jul 25, 2021

Last updated

Jun 28, 2023By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BHCADA

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.

• Kickstarting Inspiration & Nourishing Gentle Souls LLC

  • Clinical Social Worker
  • Mint Hill, NC
  • NPI 1326775883
  NPD Authorized official
• Compassion Health Care Inc

  dba CFMC Urgent Care

  • Urgent Care Clinic/Center
  • Yanceyville, NC
  • NPI 1053848820
  NPD (past)
• Compassion Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Yanceyville, NC
  • NPI 1134201387
  NPD (past)
• Voice for Children & Nurturing Families PLLC

  dba Life Synergy

  • Professional Counselor
  • Winston Salem, NC
  • NPI 1336505585
  NPD (past)

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

{
    "created_epoch": "1627171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1861165094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 HURSTON WAY",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274052948",
            "telephone_number": "252-375-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 US HIGHWAY 158 W",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273798304",
            "telephone_number": "336-694-9331",
            "fax_number": "336-694-7511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "469 Shady Grove Ct",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271035540",
            "country_code": "US",
            "telephone_number": "704-266-3049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "ZAQUES",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-25",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tania Majette, L.C.S.W.
• Margaret Michele Martin, MD
• Hubert Vernon Massengill Jr.
• Julie Kowaleski Mattice
• Tanya May
• Timothy J. McGrath, M.D.
• Mildred Blackwell (Dogwood Forest Family Care Two)
• Mildreds Family Care,Inc.
• James Millner III, PHARM D
• Frederick Ernest Moore, M.D.

• Clinical Social Worker in Yanceyville, NC
• Providers in Yanceyville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.