Mrs Susan Elyse Mccullough, FNP in Southaven, MS

Mrs Susan Elyse Mccullough, FNP is a medicare enrolled "Nurse Practitioner - Family" in Southaven, Mississippi. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Baptist Memorial Medical Group, Inc., Baptist Memorial Medical Group, Inc. and her current practice location is 7736 Airways Blvd, Southaven, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 772-5222.

Mrs Susan Elyse Mccullough is licensed to practice in Mississippi (license number 903762) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1518583129.

Contact Information

	Mrs Susan Elyse Mccullough, FNP
	7736 Airways Blvd, Southaven, MS 38671-5306
	(662) 772-5222
	(662) 772-5957

Map and Direction

Provider's Profile

Full Name	Mrs Susan Elyse Mccullough
Gender	Female
Speciality	Nurse Practitioner
Experience	5 Years
Location	7736 Airways Blvd, Southaven, Mississippi
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Susan Elyse Mccullough graduated from nursing school in 2019

NPI Data:

NPI Number: 1518583129
Provider Enumeration Date: 06/19/2020
Last Update Date: 04/19/2022

Medicare PECOS Information:

PECOS PAC ID: 4880007509
Enrollment ID: I20210119000981

Medical Identifiers

Medical identifiers for Mrs Susan Elyse Mccullough such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1518583129	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	27393 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	903762 (Mississippi)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Baptist Memorial Hospital Desoto	Southaven, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Baptist Memorial Medical Group, Inc.	5193610228	433
Baptist Memorial Medical Group, Inc.	5193610228	433

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. Mrs Susan Elyse Mccullough allows following entities to bill medicare on her behalf.

Entity Name	Baptist Memorial Medical Group, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306089206 PECOS PAC ID: 5193610228 Enrollment ID: O20101011000028

Entity Name	Desoto Family Wellness Center Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376143024 PECOS PAC ID: 2264845973 Enrollment ID: O20210119000425

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. Mrs Susan Elyse Mccullough 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
Mrs Susan Elyse Mccullough, FNP 965 Ridge Lake Blvd Ste 315, Memphis, TN 38120-9401 Ph: () -	Mrs Susan Elyse Mccullough, FNP 7736 Airways Blvd, Southaven, MS 38671-5306 Ph: (662) 772-5222

Reviews and Comments

Nurse Practitioner Nurses in Southaven, MS

Ms. Sherlean D Shugars, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2149 Stateline Rd W, Southaven, MS 38671 Phone: 662-342-1112
Penny Marie Holley, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3964 Goodman Rd E Ste 128-129, Southaven, MS 38672 Phone: 662-655-0456 Fax: 662-655-0457
Mrs. Christy Le Anne Egbert, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 122 Airways Pl, Southaven, MS 38671 Phone: 662-349-9990 Fax: 662-349-2620
Misty Burton, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 391 Southcrest Cir, Southaven, MS 38671 Phone: 662-349-2659
Rebecca Holly T Robertson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 122 Airways Pl, Southaven, MS 38671 Phone: 662-349-9990 Fax: 662-349-2620
Debra Gail Gill, RNC, MSN, WHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4892 Briarton Dr, Southaven, MS 38672 Phone: 901-262-0332
Jessica N Brown, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 55 Physicians Ln, Southaven, MS 38671 Phone: 662-655-2136

Mrs Susan Elyse Mccullough, FNP - Medicare Nurse Practitioner in Southaven, MS