Individual provider Active NPI

Tabatha Trapp McCallum, AU.D.

  • Audiologist
  • Ocala, FL
National Provider Identifier
1053622795
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY1616 Issued in FL
Practice address
40 SW 12TH St
C-201
Ocala, FL 34471-6525
Phone
(352) 351-3977
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY1616 FL Primary

Addresses

Primary practice location

40 SW 12TH St
C-201
Ocala, FL 34471-6525

Mailing address

40 SW 12TH St
C-201
Ocala, FL 34471-6525
Phone (352) 351-3977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000920 FL Practitioner - Qualified Audiologist 0345374955 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Hearing Group LLCGroup PAC ID 8325413677, 8 clinicians

Practice addresses (Care Compare)

1901 SE 18TH Ave
Suite 102
Ocala, FL 34471-8211
Phone (352) 351-3977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY1616FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Hearing Group LLC Audiologist CurrentSince Mar 1, 2023 Accepting new patients
Medical Management of Ocala Inc CurrentSince Aug 2, 2010 Accepting new patients

Locations

1901 SE 18th Ave
Ste 102
Ocala, FL 34471
Phone (352) 351-3977

2120 SW 22nd Pl
Ocala, FL 34471
Phone (352) 732-5042

15310 Amberly Dr
Ste 170
Tampa, FL 33647
Phone (813) 374-3036

149 Plantation Ridge Dr
Ste 140
Mooresville, NC 28117

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1053622795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SW 12TH ST",
            "address_2": "C-201",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344716525",
            "telephone_number": "352-351-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SW 12TH ST",
            "address_2": "C-201",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344716525",
            "telephone_number": "352-351-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLUM",
        "first_name": "TABATHA",
        "middle_name": "TRAPP",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.