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SHIR'MEL CANDIS MCCULLOUGH APRN
NPI 1629775499
Nurse Practitioner - Family in Columbia, SC

Active since February 13, 2023PECOS EnrolledAccepts Medicare Assignment
2117 GERVAIS ST, COLUMBIA, SC 29204(803) 744-0540(803) 744-0542 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 27, 2026, Feb 13, 2023 (2 updates tracked since 2023).

About Shir'mel Candis Mccullough Aprn NPPES

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

SHIR'MEL CANDIS MCCULLOUGH APRN (NPI 1629775499) is an individual family provider in Columbia, South Carolina, licensed in South Carolina (28094) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1629775499
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHIR'MEL CANDIS MCCULLOUGHCredential: APRN
Location Address2117 GERVAIS STColumbia, SC 29204-1805
Mailing AddressPo Box 3788Columbia, SC 29230-3788 · (803) 733-5959
Phone(803) 744-0540
Fax(803) 744-0542
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateFebruary 13, 2023
Last NPPES UpdateJune 24, 20262 updates tracked since enumeration
NPPES CertifiedJune 24, 2026
✔ NPI 1629775499 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
License✔ Licensed in SC · 28094
2117 GERVAIS ST, Columbia, SC 29204
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shir'mel Candis Mccullough Aprn 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 ID5597230227
PECOS Enrollment IDI20260705000055
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 Reassignments

3

Medicare enrollment records show Shir'mel Mccullough reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Eau Claire Cooperative Health Center, Inc.
Same address
Federally Qualified Health Center (FQHC)
2117 GERVAIS ST
Columbia, SC 29204
  • Reassigned Medicare billing, South Carolina enrollment
  • 145 clinicians in this Medicare group
NPI 1548571474 (803) 744-0540
Lta Wellness PLLC
903 mi
Wound Care
11211 KATY FWY
Houston, TX 77079
  • Reassigned Medicare billing, Texas enrollment
NPI 1710835822 (248) 996-7369
Iha Medical Services PLLC
906 mi
Family Medicine
1880 S DAIRY ASHFORD RD STE 401
Houston, TX 77077
  • Reassigned Medicare billing, Texas enrollment
  • 8 clinicians in this Medicare group
NPI 1003642406 (832) 903-3845

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 29204 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
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 9

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

DR. ALLISON STOUGHTON MOORE NP-C
Nurse Practitioner (Family)
2117 GERVAIS ST
COLUMBIA, SC 29204
Richland County (803) 744-0540
MRS. NICOLETTE D BURNETTE LISW
Social Worker (Clinical)
2117 GERVAIS ST
COLUMBIA, SC 29204
Richland County (803) 744-0540
ELIZABETH MUNN KROUSE
Nurse Practitioner (Family)
2117 GERVAIS ST
COLUMBIA, SC 29204
Richland County (803) 744-0540
RENEE I. L'ECUYER APRN-BC
Nurse Practitioner (Family)
2117 GERVAIS ST
COLUMBIA, SC 29204
Richland County (803) 748-1181
JOHN VAUGHN FERGUSON MD
Obstetrics & Gynecology
2117 GERVAIS ST
COLUMBIA, SC 29204
Richland County (803) 744-0540
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
2117 GERVAIS ST
COLUMBIA, SC 29204
Richland County (803) 744-0540
JENNIFER LYNN FOUQUETTE M.D.
Obstetrics & Gynecology
2117 GERVAIS ST
COLUMBIA, SC 29204
Richland County (803) 744-0540
DR. NITA THAPA MD
Obstetrics & Gynecology
2117 GERVAIS ST
COLUMBIA, SC 29204
Richland County (803) 744-0540

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 Shir'mel Mccullough's NPI number?

The NPI number for Shir'mel Mccullough is 1629775499. It was assigned to this individual provider in the NPPES registry on February 13, 2023.

Where is Shir'mel Mccullough located?

Shir'mel Mccullough practices at 2117 Gervais St, Columbia, SC 29204. The listed phone number is (803) 744-0540.

What is Shir'mel Mccullough's specialty?

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

Is Shir'mel Mccullough enrolled in Medicare?

Yes. Shir'mel 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.

Which organizations bill Medicare for Shir'mel Mccullough's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shir'mel Mccullough reassigns Medicare benefits to 3 organizations: Eau Claire Cooperative Health Center, Inc. (Columbia, SC), Lta Wellness PLLC (Houston, TX) and Iha Medical Services PLLC (Houston, TX). Each 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 Shir'mel Mccullough's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shir'mel Mccullough accept?

Health plans from Blue Cross and Blue Shield of Texas list Shir'mel 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.

When was this NPI record last updated?

The NPPES record for Shir'mel Mccullough was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.