Active NPI
Jeremy McCallister, AUD
- Audiologist
- Springfield, PA
National Provider Identifier
1053637009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AT005900
- Practice address
- 900 Old Marple Rd
Springfield, PA 19064-1211 - Phone
- (610) 328-1166
- Fax
- (610) 328-2023
- NPI assigned
- Apr 15, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | AT005900 | PA | Primary |
Addresses
Primary practice location
900 Old Marple Rd
Springfield, PA 19064-1211
Mailing address
900 Old Marple Rd
Springfield, PA 19064-1211
Phone (610) 328-1166
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT005900 | PA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Remote Neuromonitoring Physicians ,PC | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271289600000",
"number": "1053637009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 OLD MARPLE RD",
"city": "SPRINGFIELD",
"state": "PA",
"postal_code": "190641211",
"telephone_number": "610-328-1166",
"fax_number": "610-328-2023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 OLD MARPLE RD",
"city": "SPRINGFIELD",
"state": "PA",
"postal_code": "190641211",
"telephone_number": "610-328-1166",
"fax_number": "610-328-2023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCALLISTER",
"first_name": "JEREMY",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-15",
"last_updated": "2010-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "PA",
"license": "AT005900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.