Individual provider Active NPI

Joshua John McCallum, PT DPT

  • Physical Therapist
  • Nashville, TN
National Provider Identifier
1417641135
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11836 Issued in TN
Practice address
11 Vaughns Gap Rd
Nashville, TN 37205-4303
Phone
(615) 988-6852
Fax
(606) 324-0616
NPI assigned
Jun 6, 2023
Last updated
Jun 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 11836 TN Primary

Addresses

Primary practice location

11 Vaughns Gap Rd
Nashville, TN 37205-4303

Mailing address

1212 Bath Ave Ste 350
Ashland, KY 41101-3685
Phone (606) 324-0540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11836TNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1417641135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 BATH AVE STE 350",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411013685",
            "telephone_number": "606-324-0540",
            "fax_number": "606-324-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 VAUGHNS GAP RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372054303",
            "telephone_number": "615-988-6852",
            "fax_number": "606-324-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLUM",
        "first_name": "JOSHUA",
        "middle_name": "JOHN",
        "credential": "PT DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.