Paul Edward Callicoat Jr., MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

17987 Issued in OK

Practice address

900 E 13TH St
Suite 200
Grove, OK 74344-2975

Phone

(918) 786-7667

Fax

(918) 786-7699

NPI assigned

Jul 18, 2005

Last updated

May 20, 2010By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8425/brand/1/csg/1/fhir/r4

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.

• Grand Lake Regional Cardiology Services LLC

  • Interventional Cardiology Physician
  • Grove, OK
  • NPI 1811996861
  NPD (past) Authorized official
• Regional Cardiology PA

  • Interventional Cardiology Physician
  • Grove, OK
  • NPI 1225037229
  Authorized official Same address or phone
• Baptist Healthcare of Oklahoma

  dba Integris Grove General Hospital ER Physicians

  • Emergency Medicine Physician
  • Grove, OK
  • NPI 1316915564
  NPD (past)
• Sjmgroup

  • Endocrinology, Diabetes & Metabolism Physician
  • Englewood, CO
  • NPI 1376590034
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1063411536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450968",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743450968",
            "telephone_number": "918-786-7667",
            "fax_number": "918-786-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E 13TH ST",
            "address_2": "SUITE 200",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743442975",
            "telephone_number": "918-786-7667",
            "fax_number": "918-786-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLICOAT",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "17987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100034060A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Buchanan, MASTERS IN COUNSELIN
• Kimberly Rene Buffalo, NURSE PRACTITIONER
• Robert Franklyn Burke, O.D.
• Renee Burks
• Teresa Kay Butler, DPH
• Paula Calvin
• Sydney Cantwell, RN
• Jill Jolene Carbajal, APRN, FNP-C
• Carl's Hometown Pharmacy LLC (Carl's Hometown Pharmacy)
• Shauna Leann Carriger, MS, CCC-SLP

• Cardiovascular Disease Physician in Grove, OK
• Providers in Grove, OK by specialty
• Cardiovascular Disease Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.

Verify at the official NPI Registry.