Individual provider Active NPI

Myrtle Nesin McCullagh, DPT

  • Physical Therapist
  • Claremont, NH
National Provider Identifier
1891175394
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3927 Issued in NH
Practice address
5 Nursing Home Dr
Claremont, NH 03743-7344
Phone
(603) 542-9511
NPI assigned
Jun 1, 2015
Last updated
Jun 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3927 NH Primary

Addresses

Primary practice location

5 Nursing Home Dr
Claremont, NH 03743-7344

Mailing address

5 Nursing Home Dr
Claremont, NH 03743-7344
Phone (603) 542-9511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170413000809 NH Practitioner - Physical Therapist in Private Practice 8820374465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Universal Physical Therapy, LLCGroup PAC ID 5294702965, 3 clinicians

Practice addresses (Care Compare)

23 Main St
Newport, NH 03773-1504
Phone (603) 863-3260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3927NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Physical Therapy, LLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients

Locations

23 Main St
Newport, NH 03773
Phone (603) 863-3260

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1891175394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NURSING HOME DR",
            "city": "CLAREMONT",
            "state": "NH",
            "postal_code": "037437344",
            "telephone_number": "603-542-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 NURSING HOME DR",
            "city": "CLAREMONT",
            "state": "NH",
            "postal_code": "037437344",
            "telephone_number": "603-542-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLAGH",
        "first_name": "MYRTLE",
        "middle_name": "NESIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "3927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.