Individual provider Active NPI

Patricia Callow

  • Nurse Practitioner
  • Newtown Square, PA
National Provider Identifier
1336673227
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP017394 Issued in PA
Practice address
40 Media Line Rd
Newtown Square, PA 19073-4647
Phone
(610) 304-2862
NPI assigned
Apr 18, 2017
Last updated
Apr 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP017394 PA Primary

Addresses

Primary practice location

40 Media Line Rd
Newtown Square, PA 19073-4647

Mailing address

40 Media Line Rd
Newtown Square, PA 19073-4647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170606000756 PA Practitioner - Nurse Practitioner 1759658164 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP017394PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. CurrentSince Apr 9, 2018 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Apr 9, 2018 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. Past Accepting new patients

Locations

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1098 W Baltimore Pike
Ste 3101
Media, PA 19063
Phone (610) 891-9277

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1336673227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MEDIA LINE RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190734647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MEDIA LINE RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190734647",
            "telephone_number": "610-304-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLOW",
        "first_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP017394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown Square, PA

Sources for this page

Verify at the official NPI Registry.