Katie Callaway, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704297094 Issued in MI

Practice address

3901 Beaubien St
Detroit, MI 48201-2119

Phone

(313) 745-5260

NPI assigned

Sep 18, 2018

Last updated

Sep 18, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katie Spade Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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

• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1184471690
  NPD
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1811920549
  NPD
• Watch US Grow Pediatrics PC

  • Pediatrics Physician
  • Trenton, MI
  • NPI 1134649387
  NPD (past)

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1033693916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAWAY",
        "first_name": "KATIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704297094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "SPADE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ricardo James Calhoun, COUNSELOR
• Ashlynn Kathleen Calka
• Katherine Ann Calkins, FNP
• Michael Urban Callaghan, M.D.
• Destiny Callaham-Wilson
• Dorothy Callen
• Callie's Helping Hands
• Emily Callis
• Amor Calloway, LLPC
• Dawn Marie Calloway

• Pediatric Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.