Daniel John Callahan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9243 Issued in GA

Practice address

100 Genevieve CT Ste a
Peachtree City, GA 30269

Phone

(770) 486-1818

Fax

(855) 313-2098

NPI assigned

Feb 13, 2019

Last updated

Sep 25, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Laboratory Fitness LLCGroup PAC ID 1052858628, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: daniel.callahan.1@19873.direct.athenahealth.com
• Direct secure messaging: daniel.callahan.1@8042.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment Care Compare group
• Laboratory Fitness, LLC

  • Physical Therapy Clinic/Center
  • Peachtree City, GA
  • NPI 1043969264
  Care Compare group
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1265998439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GENEVIEVE CT STE A",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694868",
            "telephone_number": "770-486-1818",
            "fax_number": "855-313-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GENEVIEVE CT STE A",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "30269",
            "telephone_number": "770-486-1818",
            "fax_number": "855-313-2098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Hospital Blvd Ste 490",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300764975",
            "country_code": "US",
            "telephone_number": "470-321-7500",
            "fax_number": "678-355-4474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9243",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "PENDING",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "PENDING",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carson Alexander Bunn
• Kimberly Ann Burk, DMD
• Marcus James Burk, DMD
• Rico Bussey, D.M.D.
• Mandi Rae Call, CPM
• Janice L Calzolari, LPC
• Camber Dougher, LCSW
• Brandi Campbell, MD
• Pamela Juliet Campbell, BA, IBCLC
• Sheila Sheftall Cannon, MD

• Physician Assistant in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.