DR. CATRELL J. MCCULLOCH (NPI# 1336168020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336168020 |
| Entity Type | Individual |
| Full Name | DR. CATRELL J. MCCULLOCH |
| Credential | M.D. |
| Practice Address |
4571 N Market St Shreveport LA 71107-2917 |
| Mailing Address |
Po Box 7312 Shreveport LA 71137-7312 |
| Practice Telephone | 3189340097 |
| Practice Fax Number | 8882859932 |
| Mailing Telephone | 3189340097 |
| Mailing Fax Number | 8882859932 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2019-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 020151 | LA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | O20151 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1956252 | 05 |
| Street Address |
4571 N MARKET ST |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71107-2917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710525738 | Tierra Demming | Case Manager/Care Coordinator | 4571 N Market St, Shreveport, LA 71107-2917 | 2019-12-20 |
| 1326699208 | Shamkea Dixon | Case Manager/Care Coordinator | 4571 N Market St, Shreveport, LA 71107-2917 | 2019-09-23 |
| 1659922524 | Johnna Williams | Case Manager/Care Coordinator | 4571 N Market St, Shreveport, LA 71107-2917 | 2019-09-23 |
| 1245889138 | Niara Talton | Case Manager/Care Coordinator | 4571 N Market St, Shreveport, LA 71107-2917 | 2019-09-04 |
| 1770135626 | Kadavion Evans | Case Manager/Care Coordinator | 4571 N Market St, Shreveport, LA 71107-2917 | 2019-07-11 |
| 1548824493 | Pam Peters | Case Manager/Care Coordinator | 4571 N Market St, Shreveport, LA 71107-2917 | 2019-04-25 |
| 1275197121 | Demetrial Houston | Case Manager/Care Coordinator | 4571 N Market St, Shreveport, LA 71107-2917 | 2019-04-25 |
| 1326499922 | Teriana Pierre | Social Worker | 4571 N Market St, Shreveport, LA 71107-2917 | 2016-06-24 |
| 1528415783 | Yomeka M Evans | Case Manager/Care Coordinator | 4571 N Market St, Shreveport, LA 71107-2917 | 2016-05-18 |
| 1275907560 | Leah L Pace | Social Worker | 4571 N Market St, Shreveport, LA 71107 | 2015-11-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490875 | Kimber Leigh Lumley | Registered Nurse | 1440 Hawn Ave., Shreveport, LA 71107 | 2019-08-01 |
| 1871063461 | Nicole Capito | Case Manager/Care Coordinator | 200 North Thomas Drive Ste 1, Shreveport, LA 71107 | 2018-11-27 |
| 1891260899 | Danielle Leigh Dreher | Dental Assistant | 3610 Gorman Rd, Shreveport, LA 71107 | 2018-10-05 |
| 1255817540 | Shirley Marie Washington | Technician | 3227 Old Mooringsport Rd., Shreveport Rd, LA 71107 | 2018-07-19 |
| 1366928467 | Katrina L Bailey | Case Manager/Care Coordinator | 1111 Hawn Ave Apt A, Shreveport, LA 71107 | 2018-07-12 |
| 1063907970 | James Mcneely IIi | Public Health or Welfare | 5922 Alaska Ln, Shreveport, LA 71107 | 2018-06-25 |
| 1528560067 | Jacarie Guice | Case Manager/Care Coordinator | 4601 N. Market Ste 2, Shreveport, LA 71107 | 2018-03-01 |
| 1467971069 | Tracy Renard Harris | Counselor | 1149 Englemeade Dr, Shreveport, LA 71107 | 2017-09-14 |
| 1427588045 | Mark Rogers | Behavior Technician | 1500 N. Market Unit C Suite 105, Shreveport, LA 71107 | 2017-06-15 |
| 1356871164 | Hope4youth | Voluntary or Charitable | 2850 King Oaks Loop, Shreveport, LA 71107 | 2017-06-14 |
| Find all providers in zip 71107 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619311438 | Amanda Vice Haynie | Pediatrics | 2225 Line Avenue, Mid City Pediatrics, Shreveport, LA 71104 | 2013-04-23 |
| 1487913976 | Greg M Oji | Pediatrics | 2508 Bert Kouns Industrial Loop Ste 320, Shreveport, LA 71118-3154 | 2012-05-03 |
| 1497011001 | Tamara Lynn Moore | Pediatrics | 1811 E Bert Kouns Industrial Loop Ste 140, Shreveport, LA 71105-5741 | 2012-04-09 |
| 1316228984 | Choice Pediatrics, LLC | Pediatrics | 6930 Fern Ave, Suite 150, Shreveport, LA 71105-4100 | 2011-09-08 |
| 1598077323 | Virginia Homza Carter | Pediatrics | 909 Olive St, Shreveport, LA 71104 | 2010-07-09 |
| 1891938239 | Nicolette Humphries | Pediatrics | 2518 Bert Kouns Ind. Loop, Shreveport, LA 71118-3112 | 2009-04-15 |
| 1407042435 | Hester Suh | Pediatrics | 2709 Mackey Ln, Shreveport, LA 71118-2556 | 2007-09-24 |
| 1639203367 | Suyah M Loud | Pediatrics | 4140 Hollywood Ave, Suite B-2, Shreveport, LA 71109-7818 | 2007-03-15 |
| 1891833869 | Holliway Medical Clinic LLC | Pediatrics | 3824 Hearne Ave, Shreveport, LA 71103 | 2007-02-02 |
| 1134295520 | D Gene Mack Jr Md and Willis-knighton Medical Center | Pediatrics | 1799 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5561 | 2006-11-28 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71107 |
Please comment or provide details below to improve the information on DR. CATRELL J. MCCULLOCH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.