Scott Michael Kallor, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

042001 Issued in CT

Practice address

705 Bloomfield Ave
Suite 101
Bloomfield, CT 06002-2479

Phone

(860) 286-0444

Fax

(860) 286-0464

NPI assigned

Jul 8, 2005

Sex

Male

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)

Not enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Pediatric Partners, LLC

  • Pediatric Adolescent Medicine Physician
  • Bloomfield, CT
  • NPI 1568805059
  NPD (past) Authorized official

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1336147917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 BLOOMFIELD AVE",
            "address_2": "SUITE 101",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022479",
            "telephone_number": "860-286-0444",
            "fax_number": "860-286-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 BLOOMFIELD AVE",
            "address_2": "SUITE 101",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022479",
            "telephone_number": "860-286-0444",
            "fax_number": "860-286-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLOR",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "042001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001420017",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Jorz
• Betty Joseph, PT
• Eric Joseph
• Journey to Serenity PLLC
• Judith G. Hunt, LMFT, LLC
• Jina Kang, PHARM.D.
• Alona Kantorovich, MD
• Joan Marie Karpuk, P.T.
• Herbert J Keating III, MD
• Roy A Kellerman, MD

• Pediatrics Physician in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.