Active NPI
Terrence M Callahan, DO
- Emergency Medicine Physician
- Albuquerque, NM
National Provider Identifier
1104870468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- A-1351-06
- Practice address
- 5400 Gibson Blvd SE
Albuquerque, NM 87108-4729 - Phone
- (904) 805-1300
- Fax
- (904) 805-1302
- NPI assigned
- May 20, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | A-1351-06 | NM | Primary |
Addresses
Primary practice location
5400 Gibson Blvd SE
Albuquerque, NM 87108-4729
Mailing address
PO Box 676065
Dallas, TX 75267-6065
Phone (904) 805-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A030 | Other | NM | CHAMPUS |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-1351-06 | NM | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mesa Emergency Group LLC | Emergency Medicine | 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.
-
- Emergency Medicine Physician
- Albuquerque, NM
- NPI 1912000704
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104870468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 676065",
"city": "DALLAS",
"state": "TX",
"postal_code": "752676065",
"telephone_number": "904-805-1300",
"fax_number": "904-805-1302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 GIBSON BLVD SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871084729",
"telephone_number": "904-805-1300",
"fax_number": "904-805-1302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAHAN",
"first_name": "TERRENCE",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NM",
"license": "A-1351-06",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "A030",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.