JESSICA MCCULLOCH (FNP-C) – Family Nurse Practitioner, NPI 1275101610
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,655 NURSE PRACTITIONER in UT
Provider Addresses for JESSICA MCCULLOCH (FNP-C)
280 S MAIN ST
BOUNTIFUL, UT 840106236
Phone: (801) 505-0821
Fax: (801) 505-0803
Type: Mailing
57 N 775 E
TREMONTON, UT 843374103
Phone: (435) 915-6262
Fax: (435) 201-8200
Type: Location
164 S 760 W
TREMONTON, UT 843371756
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $65.
Total Amount is formed as General ($65) + Research ($0) + Ownership ($0) = $65.
Last reported payment date: 2024-08-30 • Largest payer in this snapshot: Exeltis, USA Inc. ($29).
Total Amount
$65
General + Research + Ownership
Payments
3
Total payment records
General Amount
$65
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Exeltis, USA Inc. | $29 |
| Astellas Pharma US Inc | $22 |
| Organon LLC | $13 |
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: 2024-11-29
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 |
|---|---|---|---|---|
| I20241129000134 | I | Nurse Practitioner | UT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84010)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Family Practice | UT |
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