Active NPI
Daniel B. Maccallum, MD
- Hospitalist Physician
- Supply, NC
National Provider Identifier
1679514715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 200200728
- Practice address
- 1 Medical Center Dr
Supply, NC 28462-3350 - Phone
- (910) 755-1004
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 200200728 | NC | Primary |
| Internal Medicine Physician | 207R00000X | 200200728 | NC |
Addresses
Primary practice location
1 Medical Center Dr
Supply, NC 28462-3350
Mailing address
202 N Atlantic Ave
Southport, NC 28461-3904
Phone (910) 454-4555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89132HJ | Medicaid | NC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charleston Surgical Hospital Healthcare Group, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Surgery Physician
- Charleston, WV
- NPI 1285131144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1679514715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 N ATLANTIC AVE",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284613904",
"telephone_number": "910-454-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "SUPPLY",
"state": "NC",
"postal_code": "284623350",
"telephone_number": "910-755-1004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACCALLUM",
"first_name": "DANIEL",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NC",
"license": "200200728",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "200200728",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89132HJ",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Supply, NC
- Liberty Nursing Services, LLC (Liberty Nursing Services)
- Life, Inc. (Life, Inc./Folly Street Group Home)
- Life, Inc. (Life, Inc./Lockwood Street Group Home)
- Autumn Jean Littlebrant, LCSW
- Mark Anthony Lizak, MD
- Michelle Catherine Mackay
- Deanna England Maclaren, FNPC
- Amber Mae Marchio, AGNP-C
- Anthony R Markham, P.T.
- Rebecca Marksberry, OTRL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.