Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Connor McCullough

Individual provider Physical Therapist · NPI 1346082021

Connor McCullough is a Physical Therapist in Private Practice in Columbus, Wisconsin. Qualified in 2024, 2 years ago. Practices with Prairie Ridge Health Inc, a 68-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
2
Licensed in
WI
In the registry since
2024

Practice location Address checks out

1515 Park Ave
Columbus, WI 53925-2402
Phone: (920) 623-2200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 16816-24 (WI)

Record details

NPI number1346082021
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 12, 2024
Last updated in NPPESJune 12, 2024
Certification dateJune 12, 2024
Mailing address1515 Park Ave, Columbus, WI 53925-2402

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Prairie Ridge Health Inc — 68 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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