AMANDA MCCULLOUGH NP-C
NPI 1396144549
Nurse Practitioner - Pediatrics in Jackson, MS

Q: What is Amanda Mccullough's NPI number?

The NPI number for Amanda Mccullough is 1396144549. It was assigned to this individual provider in the NPPES registry on August 13, 2014.

Q: What is Amanda Mccullough's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Mccullough was last updated on December 12, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since August 13, 2014PECOS Enrolled

2500 N STATE ST, JACKSON, MS 39216(601) 984-6525 Get Directions Write a Review

NPPES record last updated: December 12, 2014. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Amanda Mccullough Np-c NPPES

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

AMANDA MCCULLOUGH NP-C (NPI 1396144549) is an individual pediatrics provider in Jackson, Mississippi, licensed in Mississippi (R885221) and active in the NPI registry since August 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396144549

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameAMANDA MCCULLOUGHCredential: NP-C

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address2500 N State StJackson, MS 39216-4500 · (601) 984-6525 · Fax (601) 984-5151

Phone(601) 984-6525

Sole ProprietorNo

Enumeration DateAugust 13, 2014

Last NPPES UpdateDecember 12, 2014

✔ NPI 1396144549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in MS · R885221

2500 N STATE ST, Jackson, MS 39216

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Other Identifiers 1

Medicaid08873041MS

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Mccullough Np-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

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.

Other Providers at the Same Location NPPES 20

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

LAMAR DAVIS II M.D.

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)