Callahan MC, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CALLAHAN MC, LLC

Doing business as

Callahan Court Memory Care

Practice address

1770 NW Valley View Dr
Roseburg, OR 97471-1778

Phone

(541) 673-3900

Fax

(541) 673-3105

NPI assigned

Jun 18, 2020

Last updated

Jun 18, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory A. Roderick

Title

Member

Phone

(503) 443-1818

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Callahan Court Memory Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1073139721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 SW BRIDGEPORT RD STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247790",
            "telephone_number": "503-597-4906",
            "fax_number": "503-443-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 NW VALLEY VIEW DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711778",
            "telephone_number": "541-673-3900",
            "fax_number": "541-673-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLAHAN MC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-443-1818"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "520099",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Callahan Court Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danfeng Cai, PHARM.D
• Christopher Caldwell, QMHA, CADC-R
• California Emergency Physicians Medical Group, a Professional Corp
• California Emergency Physicians Medical Group, a Professional Corp.
• Callahan Alf, LLC (Callahan Village Assisted Living)
• Callahan Village II, LLC (Callahan Village Assisted Living Community)
• Elaine H Callahan, MD
• Camille E Campanaro, OTD OTR/L
• Brieanna Lerae Campbell
• Sarah Campbell

• Assisted Living Facility in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.