Calladerm LLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

DO0000002262 Issued in TN

Legal business name

CALLADERM LLC

Practice address

8 Sheridan SQ
Suite 110
Kingsport, TN 37660-7478

Phone

(423) 408-1504

NPI assigned

Dec 21, 2012

Last updated

Apr 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jami L Reaves, D.O., F.A.O.C.D.NPI 1679783567

Title

Physician

Phone

(423) 408-1504

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jami Lynn Reaves, DO

  • Dermatology Physician
  • Kingsport, TN
  • NPI 1679783567
  Medicare reassignment Care Compare group NPD Authorized official
• Hannah M Madill, NP

  • Nurse Practitioner
  • Kingsport, TN
  • NPI 1760950828
  Medicare reassignment Care Compare group NPD
• Ashlee M. Newland, P.A.

  • Physician Assistant
  • Kingsport, TN
  • NPI 1295059590
  Medicare reassignment Care Compare group
• Teresa Anne Starke, PA

  • Physician Assistant
  • Kingsport, TN
  • NPI 1073965679
  Medicare reassignment

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

{
    "created_epoch": "1356048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366156800000",
    "number": "1316283252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 SHERIDAN SQ",
            "address_2": "SUITE 110",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607478",
            "telephone_number": "423-408-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 SHERIDAN SQ",
            "address_2": "SUITE 110",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607478",
            "telephone_number": "423-408-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLADERM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-21",
        "last_updated": "2013-04-17",
        "status": "A",
        "authorized_official_last_name": "REAVES",
        "authorized_official_first_name": "JAMI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "423-408-1504",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.O., F.A.O.C.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TN",
            "license": "DO0000002262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlyn Leigh-Anne Cain
• Kristy Ryan Calderon
• Sarah Elizabeth Caldwell, P.T.
• Amanda S Calhoon, PHARMD
• Angie Nicole Calhoun
• Stephanie Calmo-Rojas, PTA
• Mary Elizabeth Calvert, MED
• Sindy Camelo, FNP-BC
• Camelot Care Centers
• Amanda Beth Campbell, FNP

• MOHS-Micrographic Surgery Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• MOHS-Micrographic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.