KATHERINE ANNMARIE AHERN MCCULLOUGH PA
NPI 1174170575
Physician Assistant in Charlotte, NC

Active since August 20, 2019PECOS EnrolledAccepts Medicare Assignment
125 QUEENS RD STE 430, CHARLOTTE, NC 28204(980) 302-6300(980) 302-6305 Get Directions Write a Review

NPPES record last updated: May 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 3, 2022, Aug 19, 2021, Jun 14, 2021 and 2 more (5 updates tracked since 2019).

About Katherine Annmarie Ahern Mccullough Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHERINE ANNMARIE AHERN MCCULLOUGH PA (NPI 1174170575) is an individual physician assistant in Charlotte, North Carolina and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent Anderson, and maintains a secondary practice location in Charlotte.

NPPES Registry Identity

NPI1174170575
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKATHERINE ANNMARIE AHERN MCCULLOUGHCredential: PA
Location Address125 QUEENS RD STE 430Charlotte, NC 28204-3215
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Fax(980) 302-6305
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 20, 2019
Last NPPES UpdateMay 3, 20225 updates tracked since enumeration
NPPES CertifiedMay 3, 2022
NPI 1174170575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X
125 QUEENS RD STE 430, Charlotte, NC 28204

Secondary Practice Location 1

Location 16324 Fairview Rd Ste 420Charlotte, NC 28210-3372 · Phone (980) 302-8840 · Fax (980) 302-8865

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Katherine Annmarie Ahern Mccullough Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022428663
PECOS Enrollment IDI20201110001270
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension St Vincent Anderson

Acute Care Hospitals · Anderson, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150088
Location2015 Jackson StAnderson, IN 46016 · Madison County
Emergency services Birthing friendly

Novant Health Presbyterian Medical Center

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340053
Location200 Hawthorne Lane Box 33549Charlotte, NC 28233 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
125 QUEENS RD STE 430
CHARLOTTE, NC 28204
Internal Medicine (Medical Oncology)
125 QUEENS RD STE 430
CHARLOTTE, NC 28204
Physician Assistant
125 QUEENS RD STE 430
CHARLOTTE, NC 28204
Physician Assistant
125 QUEENS RD STE 430
CHARLOTTE, NC 28204
Surgery
125 QUEENS RD STE 430
CHARLOTTE, NC 28204
Nurse Practitioner
125 QUEENS RD STE 430
CHARLOTTE, NC 28204
Internal Medicine (Pulmonary Disease)
125 QUEENS RD STE 430
CHARLOTTE, NC 28204
Internal Medicine (Hematology & Oncology)
125 QUEENS RD STE 430
CHARLOTTE, NC 28204

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 Katherine Mccullough's NPI number?

The NPI number for Katherine Mccullough is 1174170575. It was assigned to this individual provider in the NPPES registry on August 20, 2019.

Where is Katherine Mccullough located?

Katherine Mccullough practices at 125 Queens Rd Ste 430, Charlotte, NC 28204. The listed phone number is (980) 302-6300.

What is Katherine Mccullough's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Katherine Mccullough enrolled in Medicare?

Yes. Katherine Mccullough is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Katherine Mccullough accept?

Health plans from Blue Cross and Blue Shield of NC list Katherine Mccullough 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.

Is Katherine Mccullough affiliated with any hospitals?

According to CMS data, Katherine Mccullough is affiliated with Ascension St Vincent Anderson and Novant Health Presbyterian Medical Center.

When was this NPI record last updated?

The NPPES record for Katherine Mccullough was last updated on May 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.