CHARLES LARRY JR. MCCULLOUCH (MD) – Family Medicine Physician, NPI 1710964754
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CHARLES LARRY JR. MCCULLOUCH (MD)
562 E Main St
Louisville, MS 393392742
Phone: (662) 779-5150
Type: Location
North Oliver Street, Brooksville, Noxubee County, Mississippi, 39739, United States
BROOKSVILLE, MS 39739
Phone: (662) 738-4424
Fax: (662) 738-4615
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-07-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040713001089 | I | Emergency Medicine | MS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 43 | 38 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 37 | 33 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 12 | 12 | $0 |
Insurance plans in this area (ZIP 39339)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | TX | |
| Family Practice | MS | |
| Family Practice | MS | |
| - | MD | |
| Emergency Medicine | LA | |
| Internal Medicine, Emergency Medicine | MS | |
| Internal Medicine, Family Practice | MO | |
| Family Practice, Emergency Medicine | MS | |
| Osteopathic Manipulative Medicine, Emergency Medicine | MS | |
| Emergency Medicine | MS |
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