Shirley L McCallum

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

353888 Issued in WI

Practice address

1675 Highland Ave
Mail Code: 1510
Madison, WI 53792-1510

Phone

(608) 890-8298

Fax

(608) 262-1636

NPI assigned

Jan 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shirley L McCandless Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1427389139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 HIGHLAND AVE",
            "address_2": "MAIL CODE: 1510",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537921510",
            "telephone_number": "608-890-8298",
            "fax_number": "608-262-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 HIGHLAND AVE",
            "address_2": "MAIL CODE: 1510",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537921510",
            "telephone_number": "608-890-8298",
            "fax_number": "608-262-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLUM",
        "first_name": "SHIRLEY",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "353888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED DIETITIAN",
            "identifier": "1857-29",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "MCCANDLESS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy E McCabe, PA-C
• Stephanie McCaig, O.D.
• Kendra Elizabeth McCain, OTR/L
• Steven David McCall, CAPSW
• Monet Cordella McCalla, DO
• Martha McCamy, LPC-IT
• Brianna McCann
• Nikyra McCann
• Peter J McCanna, MD
• Sheba McCants

• Registered Dietitian in Madison, WI
• Providers in Madison, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.