Organization Active NPI

Callenberger Orthopedic Specialists LLC

  • Orthopaedic Surgery Physician
  • Merritt Island, FL
National Provider Identifier
1487803698
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
8441 Issued in FL
Legal business name
CALLENBERGER ORTHOPEDIC SPECIALISTS LLC
Practice address
205 N Banana River Dr
Suite 103
Merritt Island, FL 32952-2596
Phone
(321) 305-4931
Fax
(321) 305-4933
NPI assigned
Sep 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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

Authorized official

Name
Dr. Mark Steven Callenberger, D.O.NPI 1629060512
Title
Owner
Phone
(321) 305-4931

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 8441 FL Primary

Addresses

Primary practice location

205 N Banana River Dr
Suite 103
Merritt Island, FL 32952-2596

Mailing address

205 N Banana River Dr
Suite 103
Merritt Island, FL 32952-2596
Phone (321) 305-4931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081106000417 FL Part B Supplier - Clinic/Group Practice 3375602238 Receives reassigned benefits from 1 practitioner
Practice locations: Cocoa Beach, FL

National Provider Directory

National Provider Directory

Locations

333 W Cocoa Beach Cswy
Ste E
Cocoa Beach, FL 32931

205 N Banana River Dr
Ste 103
Merritt Island, FL 32952
Phone (321) 305-4931

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246406400000",
    "number": "1487803698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N BANANA RIVER DR",
            "address_2": "SUITE 103",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329522596",
            "telephone_number": "321-305-4931",
            "fax_number": "321-305-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BANANA RIVER DR",
            "address_2": "SUITE 103",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329522596",
            "telephone_number": "321-305-4931",
            "fax_number": "321-305-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLENBERGER ORTHOPEDIC SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2009-07-01",
        "status": "A",
        "authorized_official_last_name": "CALLENBERGER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-305-4931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "8441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; 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.