Individual provider Active NPI

Fallon Callahan

  • Pharmacist
  • Madison, CT
National Provider Identifier
1609358050
Registry record updated Sep 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0014578 Issued in CT
Practice address
136 Samson Rock Drive
Madison, CT 06413
Phone
(203) 245-7467
NPI assigned
Sep 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0014578 CT Primary

Addresses

Primary practice location

136 Samson Rock Drive
Madison, CT 06413

Mailing address

63 Beech Tree Ridge
Killingworth, CT 06419

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

State licenses

LicenseStateTypeSpecialty
PCT.0014578CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1535846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535846400000",
    "number": "1609358050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BEECH TREE RIDGE",
            "city": "KILLINGWORTH",
            "state": "CT",
            "postal_code": "06419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SAMSON ROCK DRIVE",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "06413",
            "telephone_number": "203-245-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "FALLON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-02",
        "last_updated": "2018-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0014578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2018; 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.