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KIM MCCULLOUGH F.N.P.
NPI 1174970487
Nurse Practitioner - Family in Brandon, FL

Active since May 17, 2016PECOS Enrolled
1367 OAKFIELD DR, BRANDON, FL 33511(813) 643-1242(813) 643-1246 Get Directions Write a Review

NPPES record last updated: September 26, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 20, 2020, May 17, 2016 (2 updates tracked since 2016).

About Kim Mccullough F.n.p. NPPES

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

KIM MCCULLOUGH F.N.P. (NPI 1174970487) is an individual family provider in Brandon, Florida, licensed in Florida (11013478) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174970487
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKIM MCCULLOUGHCredential: F.N.P.
Location Address1367 OAKFIELD DRBrandon, FL 33511-4841
Mailing Address1367 Oakfield DrBrandon, FL 33511-4841 · (813) 643-1242 · Fax (813) 643-1246
Phone(813) 643-1242
Fax(813) 643-1246
Sole ProprietorNo
Enumeration DateMay 17, 2016
Last NPPES UpdateSeptember 26, 20232 updates tracked since enumeration
NPPES CertifiedOctober 25, 2022
✔ NPI 1174970487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in FL · 11013478✔ Licensed in IN · 71006232A
1367 OAKFIELD DR, Brandon, FL 33511
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kim Mccullough F.n.p. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Kim Mccullough reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Knox Winamac Community Health Centers Inc
952 mi
Federally Qualified Health Center (FQHC)
1002 S EDGEWOOD DR
Knox, IN 46534
  • Reassigned Medicare billing, Indiana enrollment
  • 13 clinicians in this Medicare group
NPI 1629248919 (574) 772-6030

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33511 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kim Mccullough's NPI number?

The NPI number for Kim Mccullough is 1174970487. It was assigned to this individual provider in the NPPES registry on May 17, 2016.

Where is Kim Mccullough located?

Kim Mccullough practices at 1367 Oakfield Dr, Brandon, FL 33511. The listed phone number is (813) 643-1242.

What is Kim Mccullough's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kim Mccullough enrolled in Medicare?

Yes. Kim Mccullough is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kim Mccullough's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kim Mccullough reassigns Medicare benefits to Knox Winamac Community Health Centers Inc (Knox, IN). The 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 Kim Mccullough's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kim Mccullough was last updated on September 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.