JORDAN CULLEY – Physician Assistant, NPI 1124831649

JORDAN CULLEY is a healthcare provider. based in Mechanicsville, Virginia. specializing in PHYSICIAN ASSISTANT. The NPI Number for JORDAN CULLEY is 1124831649

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
JORDAN CULLEY
NPI
1124831649
Phone
Not provided
Address
10054 ATLEE STATION RD
Enumeration Date
29 January 2025
Last Update Date
29 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8048770008
Graduation Year
2024 (2 years ago)
PAC ID
5698290278
Group Practice PAC ID
3375710619
Professional Enrollment ID
I20250416000725
Address ID
VA232352349RI3000XRDXX500
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

4,429 PHYSICIAN ASSISTANT in VA

Provider Addresses for JORDAN CULLEY

  • 10054 ATLEE STATION RD

    MECHANICSVILLE, VA 231168713

    Phone:

    Type: Mailing

  • 1800 GLENSIDE DR

    RICHMOND, VA 232263769

    Phone: (804) 673-5614

    Type: Location

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: 2025-04-16

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250416000725IPhysician AssistantVATBD

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.

Verify on CMS Revalidation Lookup Tool

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 23116)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375710619View full group profile
NameSpecialtyState
Interventional Pain Management, Physical Medicine And RehabilitationVA
Orthopedic SurgeryVA
Orthopedic SurgeryVA
Nurse PractitionerVA
Orthopedic SurgeryVA
N E U R O L O G YMA
Hand SurgeryVA
Orthopedic SurgeryFL
Family PracticeVA
Family Practice, Sports MedicineVA

Reviews

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Frequently asked questions

How is JORDAN CULLEY identified in CMS data?
CMS-hosted NPPES data lists JORDAN CULLEY with NPI 1124831649.
Is JORDAN CULLEY still practicing?
JORDAN CULLEY is currently listed as active in the public NPI registry.
What healthcare role does JORDAN CULLEY hold?
Scheduling teams often label JORDAN CULLEY under Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is JORDAN CULLEY based?
JORDAN CULLEY is tied to Mechanicsville, Virginia in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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