Samuel Scott Mccullough Iii, FNP-C in Madison, MS

Samuel Scott Mccullough Iii, FNP-C is a medicare enrolled "Nurse Practitioner" in Madison, Mississippi. His current practice location is 120 Fountains Blvd # 1000, Madison, Mississippi. You can reach out to his office (for appointments etc.) via phone at (763) 300-0700.

Samuel Scott Mccullough Iii is licensed to practice in Mississippi (license number 903614) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1750923538.

Contact Information

	Samuel Scott Mccullough Iii, FNP-C
	120 Fountains Blvd # 1000, Madison, MS 39110-6343
	(763) 300-0700
	Not Available

Map and Direction

Provider's Profile

Full Name	Samuel Scott Mccullough Iii
Gender	Male
Speciality	Nurse Practitioner
Location	120 Fountains Blvd # 1000, Madison, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750923538
Provider Enumeration Date: 10/12/2019
Last Update Date: 10/12/2019

Medicare PECOS Information:

PECOS PAC ID: 2961844519
Enrollment ID: I20240528002401

Medical Identifiers

Medical identifiers for Samuel Scott Mccullough Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750923538	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	903614 (Mississippi)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samuel Scott Mccullough Iii allows following entities to bill medicare on his behalf.

Entity Name	Synergy Wound Care Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225883184 PECOS PAC ID: 2163864711 Enrollment ID: O20240528002306

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel Scott Mccullough Iii is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Samuel Scott Mccullough Iii, FNP-C 144 Huber St, Madison, MS 39110-6983 Ph: (601) 260-9830	Samuel Scott Mccullough Iii, FNP-C 120 Fountains Blvd # 1000, Madison, MS 39110-6343 Ph: (763) 300-0700

Reviews and Comments

Nurse Practitioner Nurses in Madison, MS

Catherine Elizabeth Clingan, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 129 Fountains Blvd Ste 201, Madison, MS 39110 Phone: 769-300-0730
Mallory Elizabeth Boggs, A-GNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 159 Fountains Blvd Ste B, Madison, MS 39110 Phone: 601-859-8200
Mary Hamilton Harkins, MSN, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1082 Gluckstadt Rd, Madison, MS 39110 Phone: 601-707-5621
Mrs. Sydney Mccary Ponder, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 401 Baptist Dr Ste 301, Madison, MS 39110 Phone: 601-973-1571 Fax: 601-973-1577
Ms. Larona Rachelle Searcy, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 161 Woodland Dr, Madison, MS 39110 Phone: 601-503-0335
Allison Ayers Cochran, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 102 Lexington Dr Ste 100, Madison, MS 39110 Phone: 601-973-1688 Fax: 601-973-1690
Heather Hontzas, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 159 Fountains Blvd Ste A, Madison, MS 39110 Phone: 769-231-1400

Samuel Scott Mccullough Iii, FNP-C - Medicare Nurse Practitioner in Madison, MS