Active NPI
Clara A. Callahan, MD
- General Practice Physician
- Philadelphia, PA
National Provider Identifier
1588718605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- MD021793E
- Practice address
- Jef Faculty Peds and Dupont Childrens HLTH Prog
833 Chestnut Street East Suite 300
Philadelphia, PA 19107-4413 - Phone
- (215) 955-7800
- Fax
- (215) 923-9383
- NPI assigned
- Jan 23, 2007
- Last updated
- May 2, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD021793E | PA | |
| General Practice Physician | 208D00000X | MD021793E | PA | Primary |
| Hospitalist Physician | 208M00000X | MD021793E | PA |
Addresses
Primary practice location
Jef Faculty Peds and Dupont Childrens HLTH Prog
833 Chestnut Street East Suite 300
Philadelphia, PA 19107-4413
Mailing address
Nemours Childrens Clinic
P.O. Box 404112
Atlanta, GA 30384-0001
Phone (904) 390-3610
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000860227 | Medicaid | PA | |
| 4098072 | Medicaid | MD | |
| 3774440 | Medicaid | NJ |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD021793E | PA | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209686400000",
"number": "1588718605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NEMOURS CHILDRENS CLINIC",
"address_2": "P.O. BOX 404112",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303840001",
"telephone_number": "904-390-3610",
"fax_number": "904-288-5890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JEF FACULTY PEDS AND DUPONT CHILDRENS HLTH PROG",
"address_2": "833 CHESTNUT STREET EAST SUITE 300",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074413",
"telephone_number": "215-955-7800",
"fax_number": "215-923-9383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAHAN",
"first_name": "CLARA",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2008-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD021793E",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PA",
"license": "MD021793E",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "PA",
"license": "MD021793E",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000860227",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4098072",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3774440",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.