BRIAN SHAWN MCCULLOUGH (NPI# 1225498603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225498603 |
| Entity Type | Individual |
| Full Name | BRIAN SHAWN MCCULLOUGH |
| Credential | DPH |
| Practice Address |
1701 Renaissance Blvd Ste. 120 Edmond OK 73013-3086 |
| Practice Telephone | 4058444978 |
| Practice Fax Number | 4058440562 |
| Mailing Telephone | 4058444978 |
| Mailing Fax Number | 4058440562 |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2016-02-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 10636 | OK | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780208959 | Brian Thomas Mccullough | Nurse Practitioner | 34406 N. 27th Drive, Suite 140 Office 103, Phoenix, AZ 85085-6082 | 2020-06-03 |
| 1417244716 | Brian Patrick Mccullough | Counselor | 1801 Nicollet Ave, Minneapolis, MN 55403-3791 | 2011-07-07 |
| Street Address |
1701 RENAISSANCE BLVD STE. 120 |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-3086 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427044015 | Rick D Beller | Orthopaedic Surgery | 1701 Renaissance Blvd, Suite 100, Edmond, OK 73013-3084 | 2005-09-20 |
| 1578069407 | Shawna Diane Seelbach | Nurse Practitioner | 1701 Renaissance Blvd, Edmond, OK 73013-3086 | 2018-03-31 |
| 1700248101 | Emily John | Physician Assistant | 1701 Renaissance Blvd, Edmond, OK 73013-3086 | 2016-03-24 |
| 1023488913 | Sheril Mathew | Clinical Nurse Specialist | 1701 Renaissance Blvd, Edmond, OK 73013-3086 | 2015-10-05 |
| 1710124391 | Sara Parr | Physician Assistant | 1701 Renaissance Blvd, Ste 110, Edmond, OK 73013-3086 | 2009-01-19 |
| 1861535908 | Linda Ann Zacharias | Internal Medicine | 1701 Renaissance Blvd, Edmond, OK 73013-3086 | 2007-02-15 |
| 1609939255 | Jennifer Marie Fay Damitsian | Nurse Practitioner | 1701 Renaissance Blvd, Ste 110, Edmond, OK 73013-3084 | 2006-12-18 |
| 1174558738 | Sharon P Bolton | Physician Assistant | 1701 Renaissance Blvd, Suite 110, Edmond, OK 73013-3086 | 2006-07-12 |
| 1043288673 | Craig W Carson | Internal Medicine | 1701 Renaissance Blvd, Suite 110, Edmond, OK 73013-3084 | 2006-03-09 |
| 1215905971 | Ana Kumar | Internal Medicine | 1701 Renaissance Blvd, Suite 110, Edmond, OK 73013 | 2006-03-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
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| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104099 | James R Hargis | Pharmacist | 1820 Rosedale Dr, Edmond, OK 73013-6638 | 2020-11-04 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1578175246 | Stefan Joseph Miranov | Pharmacist | 1308 N Bryant Ave, Edmond, OK 73034-4950 | 2020-08-23 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1033685730 | Chad Alan Caldwell | Pharmacist | 4833 Integris Pkwy Ste 130, Edmond, OK 73034-8864 | 2018-10-19 |
| 1881171528 | David L George | Pharmacist | 14101 N Eastern Ave Ste A, Edmond, OK 73013-5860 | 2018-07-25 |
| 1295270494 | Barbara Fang | Pharmacist | 3051 Willowood Rd, Edmond, OK 73034-9725 | 2016-12-23 |
| 1144625138 | Renae M Kraft | Pharmacist | 1101 Nw 178th St Ste A, Edmond, OK 73012-4281 | 2014-11-03 |
| 1255778452 | Shannan Denise Wideman | Pharmacist | 701 Fox Run Trl, Edmond, OK 73034-7360 | 2013-05-29 |
| 1922354208 | Kristen Winters | Pharmacist | 1701 Renaissance Blvd Ste 120, Edmond, OK 73013-3086 | 2012-07-24 |
| Find all providers in EDMOND | ||||
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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.