KELLY JO MCCULLOUGH (NPI# 1932403300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932403300 |
| Entity Type | Individual |
| Full Name | KELLY JO MCCULLOUGH |
| Credential | RD,LD |
| Practice Address |
5323 Harry Hines Blvd Dallas TX 75390-7208 |
| Mailing Address |
Po Box 845347 Dallas TX 75284-5347 |
| Practice Telephone | 2146450334 |
| Practice Fax Number | 2146450078 |
| Mailing Telephone | 2146450334 |
| Mailing Fax Number | 2146450078 |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2010-12-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | DT81969 | TX | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063802981 | Kelly Mccullough | Specialist/Technologist | 954 N County Road 250 W, Brazil, IN 47834-7495 | 2015-01-30 |
| 1285627273 | Kelly Mccullough | Nurse Practitioner | 7227 Land O Lakes Blvd, Land O Lakes, FL 34638-2826 | 2005-08-25 |
| 1417333873 | Kelly Mccullough | Counselor | 715 W Court St, Pasco, WA 99301-4153 | 2015-08-07 |
| 1942698014 | Kelly Dean Mccullough | Counselor | 6926 Ne Fourth Plain Blvd, Vancouver, WA 98661-7369 | 2014-12-24 |
| 1639515307 | Kelly Mccullough | Counselor | 3665 Kearny Villa Rd Ste 101, San Diego, CA 92123 | 2013-05-21 |
| 1497088025 | Kelly Loren Mccullough | Physician Assistant | 9104 Babcock Blvd, Suite 2120, Pittsburgh, PA 15237-5818 | 2009-09-15 |
| 1841256260 | Kelly D Mccullough | Internal Medicine | 2979 Squalicum Pkwy, Suite 301, Bellingham, WA 98225-1811 | 2006-04-25 |
| Street Address |
5323 HARRY HINES BLVD |
| City | DALLAS |
| State | TX |
| Zip Code | 75390-7208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750384434 | Wayne Edward Vinton | Nurse Anesthetist, Certified Registered | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2005-05-24 |
| 1134726441 | Franco Hernandez | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2020-10-08 |
| 1902413313 | Suzanne Largent | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2020-09-29 |
| 1518574540 | Alexandra Abele | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390 | 2020-09-24 |
| 1427660133 | Salman Kazmi | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2020-08-24 |
| 1356951800 | Teja Sebastian | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2020-08-08 |
| 1891305454 | Usamah Chaudhary | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-9006 | 2020-08-07 |
| 1700496999 | Jada Martin | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-9006 | 2020-08-03 |
| 1790395036 | Glaiza-mae Sande-docor | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2020-08-02 |
| 1326658675 | Allante Jemar Milsap | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2020-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467075655 | Richard Mark Bresler | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Mc9159, Dallas, TX 75390 | 2020-05-21 |
| 1356970735 | Fabricio Stewan Feltrin | Student in an Organized Health Care Education/Training Program | 5323 Harry Hynes Boulevard, Dallas, TX 75390 | 2020-04-07 |
| 1477016467 | Seagal Raza Dauglas | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Mc9159, Dallas, TX 75390 | 2019-04-08 |
| 1831674340 | Adwoa Aninkorah | Nurse Practitioner | Ut Southwestern Medical Center 5151 Harry Hines Blvd, Dallas, TX 75390 | 2018-10-01 |
| 1194212712 | Christian Lobue | Clinical Neuropsychologist | 6333 Forest Park Road, 1st Floor, Bla 100, Dallas, TX 75390 | 2018-04-19 |
| 1912439720 | Linsey Lindley | Student in an Organized Health Care Education/Training Program | 5939 Harry Hines Blvd 4th Floor Suite 100, Dallas, TX 75390 | 2017-03-30 |
| 1043759418 | Alyssa Macchiaroli | Registered Nurse | 5323 Harry Hines Blvd Mail Code 8590, Dallas, TX 75390 | 2017-02-18 |
| 1609313980 | Megan Rasmussen Bollner | Physician Assistant | 5303 Harry Hines Blvd Fl 9, Dallas, TX 75390 | 2017-01-25 |
| 1518329168 | Danny Hsu Yang | Hospitalist | 6201 Harry Hines Blved, Dallas, TX 75390 | 2016-03-23 |
| 1780046532 | Omer Mirza | Hospitalist | 6201 Harry Hines Blvd Dallas, Dallas, TX 75390 | 2016-03-22 |
| Find all providers in zip 75390 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902637 | Allison Kleppe | Dietitian, Registered | 6255 Oram St Apt 106, Dallas, TX 75214-3985 | 2020-11-08 |
| 1720699945 | Brenna Mcconniel | Dietitian, Registered | 6071 Village Bend Dr Apt 103, Dallas, TX 75206-3502 | 2020-08-11 |
| 1891305314 | Patricia Rose Morrison | Dietitian, Registered | 8806 Redondo Dr, Dallas, TX 75218-4142 | 2020-08-10 |
| 1093324592 | Kara Osburn | Dietitian, Registered | 3300 Oak Lawn Ave Ste 102, Dallas, TX 75219-4236 | 2020-07-30 |
| 1083222020 | Reena Woolley | Dietitian, Registered | 5747 Sadler Cir Apt 2329, Dallas, TX 75235-6618 | 2020-07-15 |
| 1255949376 | Nicole Finken | Dietitian, Registered | 2121 N Pearl St, Dallas, TX 75201-2492 | 2020-07-14 |
| 1407473879 | Lauren Taylor Lund | Dietitian, Registered | 5219 Maple Ave Apt 2209, Dallas, TX 75235-7466 | 2020-07-01 |
| 1437774247 | Brittany A Crump | Dietitian, Registered | 2121 N Pearl St Ste 300, Dallas, TX 75201-2494 | 2020-06-08 |
| 1417571886 | Taylor Morrison | Dietitian, Registered | 4429 Hyer St, Dallas, TX 75205-1050 | 2020-06-02 |
| 1457974057 | Cammie Sharp | Dietitian, Registered | 17060 Dallas Pkwy Ste 213, Dallas, TX 75248-1900 | 2020-05-19 |
| Find all providers in DALLAS | ||||
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| 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.