Mary L Callison, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD18602 Issued in ME

Practice address

10 Goodall Drive
Sanford, ME 04073-2621

Phone

(207) 490-7790

NPI assigned

Dec 28, 2006

Last updated

Apr 16, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mousam Valley Orthopaedics PA

  • Orthopaedic Surgery Physician
  • Sanford, ME
  • NPI 1043374044
  NPD (past)
• The Medical Group Department of Goodall Hospital

  • Family Medicine Physician
  • Kennebunk, ME
  • NPI 1356356869
  NPD (past)
• Premier Medical Group, LLC

  • Family Medicine Physician
  • Tempe, AZ
  • NPI 1467534487
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1285790030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059422",
            "telephone_number": "207-283-7000",
            "fax_number": "207-282-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GOODALL DRIVE",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040732621",
            "telephone_number": "207-490-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLISON",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD18602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435883199",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maureen Brooks
• Nicole A Brzezinski, PA-C
• Brooke Butterfield
• Donna J Cady, RN
• Sheila E Calderon
• Emily Calvanese, FNP
• Cancer Care Center of York County
• Caring Unlimited (CU Transitional Housing)
• Caring Unlimited Inc (CU Shelter)
• Carleton H Mabee DDS PA

• Family Medicine Physician in Sanford, ME
• Providers in Sanford, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.