Michael Callahan, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH13419 Issued in FL

Practice address

2745 Citrus Tower Blvd
Clermont, FL 34711-6699

Phone

(352) 359-2936

NPI assigned

Feb 6, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Lake Wellness and Injury Center, PLGroup PAC ID 5395707913, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• FL PPO
• AL HMO
• FL HMO
• FL HMO D-SNP
• AL HMO D-SNP
• FL HMO C-SNP
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68

Interoperability endpoints

• Direct secure messaging: drmichael@drpeterbrockman.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Lake Wellness & Injury Center, PL

  • Chiropractor
  • Clermont, FL
  • NPI 1851579320
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612569600000",
    "number": "1003408576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 SOLWAY CT",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327122023",
            "telephone_number": "352-359-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 CITRUS TOWER BLVD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116699",
            "telephone_number": "352-359-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "MICHAEL",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-06",
        "last_updated": "2021-02-06",
        "certification_date": "2021-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Drmichael@drpeterbrockman.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "South Lake Wellness & Injury Center, PL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct address",
            "address_1": "2745 Citrus Tower Blvd",
            "city": "Clermont",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347116699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Lorilee Maria Calliste I
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• Isabella Calvani Colon
• Byron Campbell, LAT, PT
• Jenna Campbell

• Chiropractor in Clermont, FL
• Providers in Clermont, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.