MICHAEL ALLEN MCCULLOUGH (NPI# 1316298870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316298870 |
| Entity Type | Individual |
| Full Name | MICHAEL ALLEN MCCULLOUGH |
| Credential | PHD, NP-BC, AP-RN |
| Practice Address |
101 Yorktown Dr Fayetteville GA 30214-1578 |
| Practice Telephone | 7704604075 |
| Mailing Telephone | 7704604075 |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2012-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN057553NP | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962049593 | Michael Wayne Mccullough | Obstetrics & Gynecology | 500 N Keene St Ste 400, Columbia, MO 65201-8104 | 2019-12-02 |
| 1982704771 | Michael Lee Mccullough | Internal Medicine | 8411 Preston Road #200, Dallas, TX 75225 | 2006-09-22 |
| 1053415166 | Michael Warren Mccullough | Chiropractor | 6003 Overland Rd Ste 104, Ste 104, Boise, ID 83709 | 2006-09-11 |
| 1982692661 | Michael Patrick Mccullough | Podiatrist | 2200 Bryant Williams Drive, Suite 1, Klamath Falls, OR 97601-1121 | 2005-10-07 |
| 1639656523 | Michael Burks Mccullough | Optometrist | 3929 N Gloster St, Tupelo, MS 38804-0915 | 2018-07-24 |
| 1861830622 | Michael Scott Mccullough | Dentist | 11400 Palm Dr, Desert Hot Springs, CA 92240-3167 | 2013-06-13 |
| 1255448122 | Michael Mccullough I | Emergency Medicine | 2823 Fresno St, Fresno, CA 93721-1324 | 2006-08-24 |
| 1932135704 | Michael Reid Mccullough | Obstetrics & Gynecology | 643 S Great Southwest Pkwy, Suite 101, Grand Prairie, TX 75051-1056 | 2006-06-24 |
| 1902878903 | Michael Mccullough | Radiology | 3800 Reservoir Rd Nw, Washington, DC 20007-2113 | 2006-02-03 |
| 1447257019 | Michael David Mccullough | Radiology | Delaney Radiologists Group, Pllc, 1025 Medical Center Dr, Wilmington, NC 28401 | 2005-06-28 |
| Street Address |
101 YORKTOWN DR |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-1578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902856115 | Dawn Leilani Paletta | Physician Assistant | 101 Yorktown Dr, Fayetteville, GA 30214-1568 | 2006-05-10 |
| 1710385513 | Privia Pediatric Medical Group of Georgia LLC | Pediatrics | 101 Yorktown Dr, Fayetteville, GA 30214-1578 | 2014-12-10 |
| 1013313857 | Privia Medical Group of Georgia LLC | Internal Medicine | 101 Yorktown Dr, Fayetteville, GA 30214-1578 | 2014-11-05 |
| 1730580010 | Wendy E Swayne | Nurse Practitioner | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-1578 | 2014-09-05 |
| 1275965634 | Megan Michelle Hanse | Nurse Practitioner | 101 Yorktown Dr, Suite 110, Fayetteville, GA 30214-1578 | 2013-08-07 |
| 1407143852 | Alaina D'amato Burran | Physician Assistant | 101 Yorktown Dr, Suite 207, Fayetteville, GA 30214-1578 | 2011-07-06 |
| 1356632962 | Suhas Joe Samuel | Family Medicine | 101 Yorktown Dr, Suite 110, Fayetteville, GA 30214-1578 | 2011-04-29 |
| 1932416617 | Gina D Wise | Technician/Technologist | 101 Yorktown Dr, Suite 225, Fayetteville, GA 30214-1568 | 2010-09-02 |
| 1184948549 | Mukti Bhatia Kanji | Family Medicine | 101 Yorktown Dr, Suite 100, Fayetteville, GA 30214-1568 | 2010-03-15 |
| 1306010152 | Georgia Rehabilitation Center Inc | Clinic/Center | 101 Yorktown Dr, Suite 211, Fayetteville, GA 30214-1568 | 2008-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528674181 | Maggie Mullican | Nurse Practitioner | 7084 S Pleasant Ridge Dr, Fayetteville, AR 72704-5447 | 2020-09-18 |
| 1720690167 | Stephen Arthur Lepak | Nurse Practitioner | 6871 Appleton Dr, Fayetteville, PA 17222-9383 | 2020-08-18 |
| 1750990255 | Towauna Daya | Nurse Practitioner | 1338 Redwine Rd, Fayetteville, GA 30215-2509 | 2020-07-30 |
| 1316555642 | Constance Ofundem Takang | Nurse Practitioner | 110 Emerald Lake Ct, Fayetteville, GA 30215-7747 | 2020-07-22 |
| 1851916472 | Breanna Mills | Nurse Practitioner | 2623 N Fire Fly Catch Dr, Fayetteville, AR 72704-6313 | 2020-06-09 |
| 1922621069 | Laura Sarai Perez | Nurse Practitioner | 480 Lees Lake Rd, Fayetteville, GA 30214-3106 | 2020-05-23 |
| 1902431125 | Crystal Baker English | Nurse Practitioner | 113 Old Bethel Rd, Fayetteville, TN 37334-6186 | 2020-03-09 |
| 1568092708 | Stephanie Elizabeth Fields | Nurse Practitioner | 1265 Highway 54 Ste 402, Fayetteville, GA 30214-4537 | 2020-01-15 |
| 1437616364 | Andrea Teal Bergman | Nurse Practitioner | Physicians Medical Walk In Care, 2893 Huntsville Hwy, Fayetteville, TN 37334-6729 | 2019-02-27 |
| 1639634447 | Arica Adams-gro'ce | Nurse Practitioner | 4028 Lifestyle Rd, Fayetteville, NC 28312-9335 | 2019-02-06 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on MICHAEL ALLEN MCCULLOUGH.
| 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.