Elizabeth F. Callahan, M.D., LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME89181 Issued in FL

Legal business name

ELIZABETH F. CALLAHAN, M.D., LLC

Practice address

5911 N Honore Ave
Suite 210
Sarasota, FL 34243-2606

Phone

(941) 308-7546

Fax

(941) 308-7550

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Tom Sidgmore

Title

Practice Administrator

Phone

(941) 308-7546

Specialties & licenses 1

Addresses

Other identifiers 15

Other names 1

• Skin Smart Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth F Callahan, M.D., LLC

  • Specialist
  • University Park, FL
  • NPI 1477548808
  Medicare reassignment Care Compare group NPD
• William Brodie Adams, M.D.

  • Dermatology Physician
  • Louisville, KY
  • NPI 1033306568

  FL

  Medicare reassignment Care Compare group NPD
• Brittany Eberly

  • Medical Physician Assistant
  • Sarasota, FL
  • NPI 1326444712
  Medicare reassignment Care Compare group
• Kate Lauren Weed, PA-C

  • Medical Physician Assistant
  • Tallahassee, FL
  • NPI 1821248659
  Medicare reassignment Care Compare group
• Rochelle M Lamb, APN

  • Nurse Practitioner
  • Sarasota, FL
  • NPI 1427023837
  Medicare reassignment NPD
• Frederick Rodrigo Yturralde, M.D.

  • Interventional Cardiology Physician
  • Port Charlotte, FL
  • NPI 1134186372
  NPD (past)
• Jonelle K McDonnell, MD

  • Dermatology Physician
  • Cuyahoga Falls, OH
  • NPI 1003844937

  Specialist

  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1376576454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 N HONORE AVE",
            "address_2": "SUITE 210",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432606",
            "telephone_number": "941-308-7546",
            "fax_number": "941-308-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 N HONORE AVE",
            "address_2": "SUITE 210",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432606",
            "telephone_number": "941-308-7546",
            "fax_number": "941-308-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH F. CALLAHAN, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "SIDGMORE",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "941-308-7546",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME89181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D1031789",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC ID JONELLE",
            "identifier": "145A6",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "48310",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBR BCBS PROVIDER#",
            "identifier": "Y00CF",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JONELLE'S NPI",
            "identifier": "1003844937",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRR NPI",
            "identifier": "1861504045",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN JAMIE RAISOR",
            "identifier": "AK933Y",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JONELLE MEDICAL LICENSE",
            "identifier": "ME104122",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI JAMIE RAISOR",
            "identifier": "1235392424",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JONELLE CIGNA PROVIDER NUMBER",
            "identifier": "8188371",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CP NPI",
            "identifier": "1285828053",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EFC NPI",
            "identifier": "1477548808",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BC PROVIDER NUMBER",
            "identifier": "00A58",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1376576454",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7543592",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skin Smart Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Skin Smart Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.