NPIMap

Individual provider Active NPI

Charles L Maccallum, MD

  • Family Medicine Physician
  • Hudson, OH
National Provider Identifier
1295728475
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35040856M Issued in OH
Practice address
5778 Darrow Rd
Suite D
Hudson, OH 44236-3808
Phone
(330) 655-2161
Fax
(330) 650-2116
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35040856M OH Primary

Addresses

Primary practice location

5778 Darrow Rd
Suite D
Hudson, OH 44236-3808

Mailing address

5778 Darrow Rd Ste 201
Hudson, OH 44236-3808
Phone (330) 655-2161

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address charlesmaccallum@uhps.allscripts.net
Direct Messaging Address charlesmaccallum@uhps.allscripts.net
Direct Messaging Address charlesmaccallum@uhps.allscriptsdirect.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35040856MOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Physicians Network, Inc. Family Medicine Past Accepting new patients
University Primary Care Practices Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cmaccallum21061@ehrdirect.uhhospitals.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1295728475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5778 DARROW RD STE 201",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442363808",
            "telephone_number": "330-655-2161",
            "fax_number": "330-650-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5778 DARROW RD",
            "address_2": "SUITE D",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442363808",
            "telephone_number": "330-655-2161",
            "fax_number": "330-650-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCALLUM",
        "first_name": "CHARLES",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35040856M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlesmaccallum@uhps.allscripts.net",
            "affiliation": "N",
            "address_1": "5778 Darrow Rd",
            "address_2": "Suite D",
            "city": "Hudson",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442363808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlesmaccallum@uhps.allscripts.net",
            "affiliation": "N",
            "address_1": "5778 Darrow Rd",
            "address_2": "Suite D",
            "city": "Hudson",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442363808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlesmaccallum@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2885 Pioneer Trl",
            "city": "Hudson",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442361917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.