Callisto Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CALLISTO PEDIATRICS, PLLC

Practice address

320 Seagle Street Suite#10
Huntersville, NC 28078

Phone

(704) 368-4351

NPI assigned

Dec 30, 2020

Last updated

Dec 30, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tara Moon, MDNPI 1336403211

Title

Ceo

Phone

(513) 225-8170

Specialties & licenses 1

Addresses

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tara Moon, M.D.

  • Pediatrics Physician
  • Statesville, NC
  • NPI 1336403211
  NPD Authorized official
• Sophia Grace Moody, NP

  • Pediatric Nurse Practitioner
  • Huntersville, NC
  • NPI 1760183032
  NPD (past)

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1447847975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 TOWN LOOP APT B107",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281170020",
            "telephone_number": "513-225-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SEAGLE STREET SUITE#10",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "28078",
            "telephone_number": "704-368-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLISTO PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-225-8170",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.callistopediatrics.com",
            "affiliation": "N",
            "endpointDescription": "Organization Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "320 Seagle Street Suite#10",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Marie Cable
• Cali Cos Haven
• Julie L Callan, CRNA
• Capathyia S Callaway
• Aimee Calleja
• Calm Blue Waters Counseling, PLLC (Calm Blue Waters Counseling)
• Colene Marie Calo, DO
• Susana Analia Camarasa, MS
• Cami Surgery Center, PLLC
• Dennis Campbell, PTA

• Pediatrics Physician in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.