Individual provider Active NPI

Eileen Claire Callaway, M.D.

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1255751186
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME131337 Issued in FL
Practice address
10491 6 Mile Cypress Pkwy Ste 271
Fort Myers, FL 33966-6518
Phone
(239) 215-3500
Fax
(239) 215-3525
NPI assigned
Apr 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME131337 FL Primary

Addresses

Primary practice location

10491 6 Mile Cypress Pkwy Ste 271
Fort Myers, FL 33966-6518

Mailing address

10491 6 Mile Cypress Pkwy Ste 271
Fort Myers, FL 33966-6518
Phone (239) 215-3500

Other identifiers 4

IdentifierTypeStateIssuer
PNF4KOtherFLFLORIDA BLUE - BCBS
XGZN9OtherFLFLORIDA BLUE - BCBS
105682700MedicaidFL
114316000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eileen.callaway.1@26277.direct.athenahealth.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190404000470 FL Practitioner - Family Practice 5597006395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10491 6 Mile Cypress Pkwy
Suite 271
Fort Myers, FL 33966-6518
Phone (239) 215-3500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME131337FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Primary Med LLC Multi-Specialty CurrentSince Feb 26, 2022 Accepting new patients

Locations

10491 6 Mile Cypress Pkwy
Ste 271
Fort Myers, FL 33966
Phone (239) 215-3500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26277/brand/1/csg/1/fhir/r4
  • Direct secure messaging: eileen.callaway.1@26277.direct.athenahealth.com
  • Direct secure messaging: eileen.calloway@546549178499076.direct.elationemr.com

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.

Hospital & facility affiliations 5

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": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1255751186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10491 6 MILE CYPRESS PKWY STE 271",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339666518",
            "telephone_number": "239-215-3500",
            "fax_number": "239-215-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10491 6 MILE CYPRESS PKWY STE 271",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339666518",
            "telephone_number": "239-215-3500",
            "fax_number": "239-215-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAWAY",
        "first_name": "EILEEN",
        "middle_name": "CLAIRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME131337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE - BCBS",
            "identifier": "PNF4K",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE - BCBS",
            "identifier": "XGZN9",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105682700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114316000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eileen.callaway.1@26277.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address in EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10491 6 Mile Cypress Pkwy Ste 271",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339666518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.