Active NPI
Katherine E. Callahan, MD
- Neurological Surgery Physician
- Salt Lake City, UT
National Provider Identifier
1164009221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 13964186-1205
- Practice address
- 175 N Medical Dr RM 5323
Salt Lake City, UT 84112-1103 - Phone
- (801) 581-2121
- NPI assigned
- Mar 25, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 13964186-1205 | UT | Primary |
Addresses
Primary practice location
175 N Medical Dr RM 5323
Salt Lake City, UT 84112-1103
Mailing address
175 N Medical Dr RM 5323
Salt Lake City, UT 84112-1103
Phone (801) 581-2121
Other practice location 1
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-2345
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210809002699 | VT | Order and Referring Only - Neurosurgery | 7810391109 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13964186-1205 | UT | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1164009221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 N MEDICAL DR RM 5323",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841121103",
"telephone_number": "801-581-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 N MEDICAL DR RM 5323",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841121103",
"telephone_number": "801-581-2121"
}
],
"practiceLocations": [
{
"address_1": "111 Colchester Ave",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "VT",
"postal_code": "054011473",
"country_code": "US",
"telephone_number": "802-847-2345",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CALLAHAN",
"first_name": "KATHERINE",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-25",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "UT",
"license": "13964186-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.