MID-COLUMBIA DERMATOLOGY, LLC
NPI 1033457395
Nurse Practitioner in Richland, WA
About Mid-columbia Dermatology, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MID-COLUMBIA DERMATOLOGY, LLC (NPI 1033457395) is a healthcare organization registered as a nurse practitioner in Richland, Washington and active in the NPI registry since January 2013. The organization lists Jennifer Mccullugh, Managing Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mid-columbia Dermatology, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Mid-Columbia Dermatology, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mid-Columbia Dermatology, LLC's NPI number?
The NPI number for Mid-Columbia Dermatology, LLC is 1033457395. It was assigned to this organization in the NPPES registry on January 22, 2013.
Where is Mid-Columbia Dermatology, LLC located?
Mid-Columbia Dermatology, LLC is located at 309 Bradley Blvd Ste 101, Richland, WA 99352. The listed phone number is (509) 619-5936.
What is Mid-Columbia Dermatology, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Mid-Columbia Dermatology, LLC enrolled in Medicare?
Yes. Mid-Columbia Dermatology, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mid-Columbia Dermatology, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Mid-Columbia Dermatology, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Mid-Columbia Dermatology, LLC accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Mid-Columbia Dermatology, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mid-Columbia Dermatology, LLC was last updated on January 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mid-Columbia Dermatology, Llc · NPI 1033457395
Nurse Practitioner organization in Richland, Washington. Organization record, active in the CMS NPPES registry since January 22, 2013.
## Identity
- **NPI:** 1033457395 (Entity type: Organization)
- **Enumerated:** January 22, 2013
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **Organization subpart:** No
- **Authorized official:** Jennifer Mccullugh, MANAGING MEMBER
## Practice location
- **Address:** 309 BRADLEY BLVD, STE 101, Richland, WA 99352-4381
- **Phone:** (509) 619-5936
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 22, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1033457395) · Data from the CMS NPPES public registry.