Danielle Marie Callanan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2035 Issued in NV

Practice address

2647 Box Canyon Dr
Las Vegas, NV 89128-0450

Phone

(702) 363-5575

NPI assigned

Aug 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• VMD Primary Providers Nevada Asplin PC

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1285210757
  Medicare reassignment
• Robert Roth MD a Professional

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1023287695
  NPD
• Intermountain Medical Holdings Nevada Inc

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279
  NPD (past)

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1699256388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 BOX CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 BOX CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280450",
            "telephone_number": "702-363-5575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1397 S Loop Rd",
            "address_purpose": "LOCATION",
            "city": "Pahrump",
            "state": "NV",
            "postal_code": "890484729",
            "country_code": "US",
            "telephone_number": "775-727-5500",
            "fax_number": "775-727-5696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLANAN",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2035",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA2035",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699256388",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.