Organization Active NPI

Scot C. Callahan, M.D. , P.C.

  • Otolaryngology Physician
  • Enterprise, AL
National Provider Identifier
1275890840
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
18006 Issued in AL
Legal business name
SCOT C. CALLAHAN, M.D. , P.C.
Practice address
101 E Brunson St
Suite 100
Enterprise, AL 36330-2526
Phone
(334) 393-6673
Fax
(334) 347-9599
NPI assigned
Apr 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Authorized official

Name
Scot C Callahan, M.D.NPI 1023096427
Title
Owner
Phone
(334) 393-6673

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X 18006 AL Primary

Addresses

Primary practice location

101 E Brunson St
Suite 100
Enterprise, AL 36330-2526

Mailing address

101 E Brunson St
Suite 100
Enterprise, AL 36330-2526
Phone (334) 393-6673

Other identifiers 2

IdentifierTypeStateIssuer
000077626MedicaidAL
1023096427OtherNPI

Other names 1

  • Callahan ENT & Facial Plastics Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120510000304 AL Part B Supplier - Clinic/Group Practice 8729240676 Receives reassigned benefits from 1 practitioner
Practice locations: Enterprise, AL

National Provider Directory

National Provider Directory

Locations

101 E Brunson St
Ste 100
Enterprise, AL 36330
Phone (334) 393-6673

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1275890840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BRUNSON ST",
            "address_2": "SUITE 100",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302526",
            "telephone_number": "334-393-6673",
            "fax_number": "334-347-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BRUNSON ST",
            "address_2": "SUITE 100",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302526",
            "telephone_number": "334-393-6673",
            "fax_number": "334-347-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOT C. CALLAHAN, M.D. , P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "CALLAHAN",
        "authorized_official_first_name": "SCOT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-393-6673",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "18006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000077626",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1023096427",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Callahan ENT & Facial Plastics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.