NPIMap

Individual provider Active NPI

Gregory B McCallum, MD

  • Family Medicine Physician
  • Redwood Falls, MN
National Provider Identifier
1689642282
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34641 Issued in MN
Practice address
1100 East Broadway
Redwood Falls, MN 56283
Phone
(507) 637-2985
Fax
(507) 637-6678
NPI assigned
Mar 9, 2006
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34641 MN Primary

Addresses

Primary practice location

1100 East Broadway
Redwood Falls, MN 56283

Mailing address

1100 East Broadway
Redwood Falls, MN 56283
Phone (507) 637-2985

Other identifiers 1

IdentifierTypeStateIssuer
950365000MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmccallum436973@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100302000375 MN Practitioner - Family Practice 8527103514 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carris Health - Redwood LLCGroup PAC ID 7911259619, shared by 6 NPIs, 42 clinicians
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Practice addresses (Care Compare)

101 Caring Way
Redwood Falls, MN 56283-2624
Phone (507) 637-2985

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

600 Peterson Pkwy
New London, MN 56273-7823
Phone (320) 354-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Sioux Health Care Center Current Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Oct 1, 2021 Accepting new patients
Carris Health - Redwood LLC Current Accepting new patients
Carris Health - Redwood LLC CurrentSince Jun 1, 2019 Accepting new patients
Carris Health - Redwood LLC CurrentSince Jun 1, 2019 Accepting new patients
Redwood Area Hospital Current Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Oct 1, 2021 Accepting new patients
River Valley Health and Rehabilitation Center LLC Past Accepting new patients

Locations

39648 Reservation Highway 3
Morton, MN 56270
Phone (507) 697-8600

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

101 Caring Way
Redwood Falls, MN 56283
Phone (507) 637-2911

1100 E Broadway St
Redwood Falls, MN 56283
Phone (507) 637-2985

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: gmccallum436973@direct.centracare.com
  • Direct secure messaging: gregorymccallum@lshc.allscriptsdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1689642282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 EAST BROADWAY",
            "city": "REDWOOD FALLS",
            "state": "MN",
            "postal_code": "56283",
            "telephone_number": "507-637-2985",
            "fax_number": "507-637-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 EAST BROADWAY",
            "city": "REDWOOD FALLS",
            "state": "MN",
            "postal_code": "56283",
            "telephone_number": "507-637-2985",
            "fax_number": "507-637-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLUM",
        "first_name": "GREGORY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "34641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "950365000",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmccallum436973@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "gmccallum436973@direct.centracare.com",
            "address_1": "1100 East Broadway",
            "city": "Redwood Falls",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redwood Falls, MN

Sources for this page

Verify at the official NPI Registry.