Active NPI
Stefan A Calloway, O.D.
- Optometrist
- Stuttgart, AR
National Provider Identifier
1053376434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2290
- Practice address
- 713 S Main St
Stuttgart, AR 72160-4805 - Phone
- (870) 673-8529
- Fax
- (870) 673-2931
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2290 | AR | Primary |
Addresses
Primary practice location
713 S Main St
Stuttgart, AR 72160-4805
Mailing address
713 S Main St
Stuttgart, AR 72160-4805
Phone (870) 673-8529
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2290 | AR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208131200000",
"number": "1053376434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 S MAIN ST",
"city": "STUTTGART",
"state": "AR",
"postal_code": "721604805",
"telephone_number": "870-673-8529",
"fax_number": "870-673-2931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "713 S MAIN ST",
"city": "STUTTGART",
"state": "AR",
"postal_code": "721604805",
"telephone_number": "870-673-8529",
"fax_number": "870-673-2931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLOWAY",
"first_name": "STEFAN",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2008-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AR",
"license": "2290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stuttgart, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.