NPIMap

Individual provider Active NPI

Gary Brian McCallum, M.D.

  • Emergency Medicine Physician
  • Benton, AR
National Provider Identifier
1205862315
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-3712 Issued in AR
Practice address
1 Medical Park Dr
Saline Memorial Hospital
Benton, AR 72205
Phone
(501) 626-9478
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-3712 AR Primary

Addresses

Primary practice location

1 Medical Park Dr
Saline Memorial Hospital
Benton, AR 72205

Mailing address

PO Box 165257
Little Rock, AR 72216-5257
Phone (501) 626-9478

Other identifiers 2

IdentifierTypeStateIssuer
150657001MedicaidAR
5M648OtherARBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507001288 AR Practitioner - Emergency Medicine 9537158225 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arkansas College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Heart Hospital LLCGroup PAC ID 6002838653, 85 clinicians

Practice addresses (Care Compare)

1701 S Shackleford Rd
Little Rock, AR 72211-4335

7 Shackleford W Blvd
Little Rock, AR 72211-3886
Phone (501) 664-5860

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.37 of 100Reported as group
Quality
71.5
Improvement activities
40
Cost
75.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Heart Hospital, LLC CurrentSince Jan 1, 2017 Accepting new patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince Sep 1, 2011 Accepting new patients
South Arkansas Emergency Physicians LLP Emergency Medicine Current Accepting new patients
Ouachita County Medical Center CurrentSince Mar 1, 2024 Accepting new patients
Ouachita County Medical Center CurrentSince Mar 1, 2024 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Jan 1, 2017 Accepting new patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince Sep 1, 2011 Accepting new patients
St. Anthony's Hospital Association Past Accepting new patients
St. Anthony's Hospital Association Past Accepting new patients

Locations

1901 Encore Way
Bryant, AR 72019
Phone (501) 213-4500

638 California Ave SW
East Camden, AR 71701
Phone (870) 836-1000

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

1701 S Shackleford Rd
Little Rock, AR 72211
Phone (501) 219-7000

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1205862315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 165257",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722165257",
            "telephone_number": "501-626-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "address_2": "SALINE MEMORIAL HOSPITAL",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-626-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLUM",
        "first_name": "GARY",
        "middle_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-3712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150657001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5M648",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.