Callie Hall Self, AGNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

906256 Issued in MS

Practice address

104 Burney Dr
Flowood, MS 39232-6621

Phone

(601) 987-8200

Fax

(601) 987-8211

NPI assigned

Dec 12, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Callie Frances Hall Former name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capital Orthopaedic Clinic, PLLCGroup PAC ID 0941215255, 49 clinicians

KDMC Physician Clinics LLCGroup PAC ID 7012154495, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
• King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057
• Merit Health River Oaks Hospital, Flowood, MS, CCN 250138

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chall@capitalortho.emadirect.md
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://api.platform.athenahealth.com/6393/brand/1/csg/41/fhir/r4
• Direct secure messaging: chall5265958@direct.casso.us.com

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.

• Capital Orthopaedic Clinic, PLLC

  • Orthopaedic Surgery Physician
  • Flowood, MS
  • NPI 1770687881
  Medicare reassignment Care Compare group NPD
• KDMC Physician Clinics LLC

  • Multi-Specialty Clinic/Center
  • Brookhaven, MS
  • NPI 1861739161
  Medicare reassignment Care Compare group NPD
• Capital Orthopaedic Clinic PLLC

  • Orthopedic Physical Therapist
  • Flowood, MS
  • NPI 1184299273
  NPD
• Capital Orthopedic Clinic PLLC

  • Orthopaedic Surgery Physician
  • Flowood, MS
  • NPI 1215988787
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  Care Compare affiliation
• River Oaks Hospital LLC

  • General Acute Care Hospital
  • Flowood, MS
  • NPI 1396792032
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1124896980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BURNEY DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392326621",
            "telephone_number": "601-987-8200",
            "fax_number": "601-987-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BURNEY DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392326621",
            "telephone_number": "601-987-8200",
            "fax_number": "601-987-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "CALLIE",
        "middle_name": "HALL",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "906256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLIE",
            "last_name": "HALL",
            "middle_name": "FRANCES",
            "credential": "AGNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gladys Scott, NP
• Joely McDaniel Scott, NP
• Shimika Scott
• Jennifer Sears
• Segue Health of Mississippi LLC
• Rachel M Sellers, PA-C
• Sessoms Therapeutic Counseling and Consulting Services, LLC
• Shonda Monique Sessoms, LPC
• Tatum Lee Severino I, DNP, FNP-C
• Karen B. Shackelford, MD

• Nurse Practitioner in Flowood, MS
• Providers in Flowood, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.