Individual provider Active NPI

Charles Willis Callahan, DO

  • Pediatric Pulmonology Physician
  • Washington, DC
National Provider Identifier
1295823557
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
DOS719 Issued in HI
Practice address
Walter Reed Army Medical Center
Washington, DC 20907-1234
Phone
(202) 782-8397
Fax
(202) 782-4914
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X DOS719 HI Primary

Addresses

Primary practice location

Walter Reed Army Medical Center
Washington, DC 20907-1234

Mailing address

13104 Collingwood Terrace
Silver Spring, MD 20904-1234
Phone (202) 782-8397

Other practice location 1

22 S Greene St
Baltimore, MD 21201-1544
Phone (667) 214-1916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20151216000769 MD Practitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 5193711489 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DOS719HIMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Pediatric Assoc PA CurrentSince Nov 1, 2015 Accepting new patients
University of Maryland Pediatric Associates, PA Current Accepting new patients
University of Maryland Pediatric Associates, PA CurrentSince Nov 1, 2015 Accepting new patients

Locations

22 S Greene St
Fl 5
Baltimore, MD 21201
Phone (410) 328-5887

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

Interoperability endpoints

  • Direct secure messaging: ccallahan271386@direct.umm.edu

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1295823557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13104 COLLINGWOOD TERRACE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041234",
            "telephone_number": "202-782-8397",
            "fax_number": "202-782-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALTER REED ARMY MEDICAL CENTER",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "209071234",
            "telephone_number": "202-782-8397",
            "fax_number": "202-782-4914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "667-214-1916",
            "fax_number": "410-225-9405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "CHARLES",
        "middle_name": "WILLIS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "HI",
            "license": "DOS719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.