Craig F Callam, APRN, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Banning, CA
NPI 1538799747 · NPPES record last updated Jul 14, 2026
Key facts
- NPI
- 1538799747
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95239375 (CA)
- Practice address
- 11555 1/2 Potrero Rd
Banning, CA 92220-6946 - Phone
- (951) 849-4761
- Fax
- (951) 849-4651
- NPI assigned
- Jan 16, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Riverside-San Bernardino County Indian Health Inc
Practice addresses (Care Compare)
11555 /2 Potrero Rd
Banning, CA 92220-6946
Phone (951) 849-4761
11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097
23119 Soboba Rd
Soboba Indian Health Clinic
San Jacinto, CA 92583-5517
Phone (951) 654-0803
66655 Martinez Rd
Torres Martinez Indian HLTH Clin
Thermal, CA 92274-9007
Phone (760) 397-4476
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200430000005 | FL | Practitioner - Nurse Practitioner | 2365872561 | |
| I20240628001775 | TX | Practitioner - Nurse Practitioner | 2365872561 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9365661 | FL | MD | Registered Nurse |
| 11006675 | FL | MD | Nurse Practitioner |
| 95239375 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crew Community Health, Inc | Current |
Accepting new patients | |
| Riverside-San Bernardino County Indian Health, Inc | Current |
Accepting new patients | |
| Riverside-San Bernardino County Indian Health, Inc | Current |
Accepting new patients | |
| Riverside-San Bernardino County Indian Health, Inc. | Current | Accepting new patients | |
| Crew Health | Past |
Accepting new patients |
Locations
11555 Potrero Rd
#1-2
Banning, CA 92220
Phone (909) 849-4761
11555 Potrero Rd
Banning, CA 92220
Phone (800) 732-8805
11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470
8601 Commodity Cir
Orlando, FL 32819
Phone (407) 605-2252
Interoperability endpoints
- https://api.platform.athenahealth.com/22364/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN9365661 | FL | |
| Family Nurse Practitioner | 363LF0000X | APRN11006675 | FL | |
| Nurse Practitioner | 363L00000X | 11006675 | FL | |
| Family Nurse Practitioner | 363LF0000X | 95239375 | CA | Yes |
Addresses
Primary practice location
11555 1/2 Potrero Rd
Banning, CA 92220-6946
Mailing address
11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097
Other providers in Banning, CA
- Jackie Bustamante
- California Addiction Treatment Center LLC
- California Em-I Medical Services a Medical Corporation
- California Neonatology Services a Medical Corporation
- Colleen Callahan
- Crystal Capitan
- Diana Cardenas
- Laura Cardenas
- Samara Yael Cardona Espinoza
- Careridesolutions
All providers in Banning, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.