Kelly J Callaway, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4396 Issued in OK

Practice address

2067 Mahaney Ave
Tahlequah, OK 74464-5731

Phone

(918) 708-2563

Fax

(918) 456-3000

NPI assigned

Jan 6, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Countryside Wellness LLC

  • Chiropractor
  • Tahlequah, OK
  • NPI 1205142700
  Medicare reassignment Authorized official
• Del Health, LLC

  • Family Nurse Practitioner
  • Tahlequah, OK
  • NPI 1205670957
  NPD (past)

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1134585144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 MAHANEY AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645731",
            "telephone_number": "918-708-2563",
            "fax_number": "918-456-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 MAHANEY AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645731",
            "telephone_number": "918-708-2563",
            "fax_number": "918-456-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAWAY",
        "first_name": "KELLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-06",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Marie Byas, PHARMACIST
• Steve B Byrd, CST
• Holly Caddell
• Kayla Jeanne Cagle-Colon, M.D.
• Jennifer Lee Callaway, DO
• Calming Connections LLC
• Alicia Dawn Campanella, APRN-CNM
• Jennifer L Campbell, APRN, NP-C
• Sam Blake Campbell, DDS
• Joan Candy-Fire

• Chiropractor in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.