Sally Caraballo, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

2815 Issued in OH

Practice address

55 N Central Ave
Suite 3
Fairborn, OH 45324-5087

Phone

(937) 878-2800

Fax

(937) 878-7261

NPI assigned

Aug 18, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Janet R N Kail DPM

  • Foot Surgery Podiatrist
  • Fairborn, OH
  • NPI 1275840381
  NPD (past)
• Otterbein Clearcreek, LLC

  dba Avalon by Otterbein Clear Creek

  • Skilled Nursing Facility
  • Centerville, OH
  • NPI 1992977516
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659363471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 N CENTRAL AVE",
            "address_2": "SUITE 3",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453245087",
            "telephone_number": "937-878-2800",
            "fax_number": "937-878-7261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N CENTRAL AVE",
            "address_2": "SUITE 3",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453245087",
            "telephone_number": "937-878-2800",
            "fax_number": "937-878-7261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABALLO",
        "first_name": "SALLY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OH",
            "license": "2815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0173726",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deasia Campbell
• Shantel Campbell
• Laura Cano
• Cheryl Kay Cantrell
• Adrian Canty
• Seneca Marie Cardiff, DO
• Caring Solutions NP LLC
• Shelbi Carpenter
• Brendan Thomas More Carroll, M.D.
• Michael A Carter, CDC-A

• Primary Podiatric Medicine Podiatrist in Fairborn, OH
• Providers in Fairborn, OH by specialty
• Primary Podiatric Medicine Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.