AMANDA MCCULLOUGH (NPI# 1174133979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174133979 |
| Entity Type | Individual |
| Full Name | AMANDA MCCULLOUGH |
| Practice Address |
120 Nix Ridge Rd Ash Flat AR 72513-9017 |
| Practice Telephone | 8709943103 |
| Practice Fax Number | 8709943108 |
| Mailing Telephone | 8709943103 |
| Mailing Fax Number | 8709943108 |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285941468 | Amanda Jo Mccullough | Student in an Organized Health Care Education/Training Program | 4001 Westerly Pl, Suite 110, Newport Beach, CA 92660-2315 | 2010-09-09 |
| 1629013602 | Amanda Gayle Mccullough | Physical Therapist | 107 Schoolcrest Ave, Clare, MI 48617-1145 | 2006-06-17 |
| 1124639067 | Amanda Mccullough | Pharmacist | 127 E Pleasant Valley Rd, Seven Hills, OH 44131-5601 | 2020-08-13 |
| 1396144549 | Amanda Mccullough | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2014-08-13 |
| Street Address |
120 NIX RIDGE RD |
| City | ASH FLAT |
| State | AR |
| Zip Code | 72513-9017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306979265 | From The Beginning Chms Clinic | Clinic/Center | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2007-03-13 |
| 1154971885 | Emily Elizabeth Gardner | Specialist/Technologist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2019-09-15 |
| 1750874566 | Rachel Vannattan | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2018-06-07 |
| 1912434499 | Mary Thompson | Specialist/Technologist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2017-05-16 |
| 1881968592 | Dawn Perkins | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-27 |
| 1548533573 | Alicia Finchem | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-22 |
| 1992078927 | Karen Mcdonald | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-22 |
| 1457624264 | Linda Hutchins | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-10 |
| 1831462639 | Tarah Lopez | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-10 |
| 1073886883 | Jacquelyn Smith | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972073450 | Hope Satterwhite | Speech-Language Pathologist | 120 Nix Rd, Ash Flat, AR 72513 | 2018-11-28 |
| 1356816110 | Garrett Andrew Sublett | Occupational Therapy Assistant | 83-1 Tuff St, Ash Flat, AR 72513 | 2018-10-09 |
| 1821540626 | Phillip Michael Taylor | Case Manager/Care Coordinator | 75 Hwy 62 - 412, Ash Flat, AR 72513 | 2016-10-27 |
| 1174079453 | Isaacs Occupational Therapy, LLC | Occupational Therapist | 33 Court Rd, Ash Flat, AR 72513 | 2016-08-28 |
| 1275899726 | David Bryant | Case Manager/Care Coordinator | 75 Hwy 75-612, Ash Flat, AR 72513 | 2012-04-10 |
| 1235375734 | Health Resources of Arkansas, Inc. | Community/Behavioral Health | 714 Ash Flat Dr, Ash Flat, AR 72513 | 2009-01-05 |
| 1336303262 | Melinda Wallis | Case Manager/Care Coordinator | Remington Plaza 75k Hwy 62/142, Ash Flat, AR 72513 | 2008-07-10 |
| 1336306596 | Stephanie Chapps | Case Manager/Care Coordinator | 75 Hwy 62-412, Ash Flat, AR 72513 | 2008-05-16 |
| 1598985863 | Network of Community Options Inc. | Day Training, Developmentally Disabled Services | 10 Martin Lane, Ash Flat, AR 72513 | 2007-04-27 |
| 1386864882 | Melanie Ann Isaacs | Occupational Therapist | #873 Hwy 354, Ash Flat, AR 72513 | 2007-04-26 |
| Find all providers in zip 72513 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639558828 | Heather Harlow | Day Training/Habilitation Specialist | 685 Day Rd, Ash Flat, AR 72513-9317 | 2015-05-21 |
| 1740685015 | Cassidy Berton | Day Training/Habilitation Specialist | 34 Sharon Cir, Ash Flat, AR 72513-9409 | 2014-10-29 |
| 1881959021 | Jessica Lacount | Day Training/Habilitation Specialist | 512 Old Peace Valley Rd, Ash Flat, AR 72513-9859 | 2012-07-12 |
| 1326311234 | Tiffany Lillian Kellems | Day Training/Habilitation Specialist | 47 Agnos Rd, Ash Flat, AR 72513-9778 | 2012-02-23 |
| 1750874566 | Rachel Vannattan | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2018-06-07 |
| 1881968592 | Dawn Perkins | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-27 |
| 1548533573 | Alicia Finchem | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-22 |
| 1992078927 | Karen Mcdonald | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-22 |
| 1457624264 | Linda Hutchins | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-10 |
| 1831462639 | Tarah Lopez | Day Training/Habilitation Specialist | 120 Nix Ridge Rd, Ash Flat, AR 72513-9017 | 2012-02-10 |
| Find all providers in ASH FLAT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.