Mia McCallum

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

289029 Issued in AZ

Practice address

7555 E Osborn Rd Ste 106
Scottsdale, AZ 85251-6482

Phone

(480) 609-8100

NPI assigned

Sep 15, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1386452415
  NPD
• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1558308825
  NPD
• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1811490881
  NPD
• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1669878567
  NPD (past)
• Mountain Park Health Center - Dental

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1710146188
  NPD (past)
• North Scottsdale Pediatric Associates

  • Pediatrics Physician
  • Scottsdale, AZ
  • NPI 1275797235
  NPD (past)

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702771200000",
    "number": "1700508876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7555 E OSBORN RD STE 106",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516482",
            "telephone_number": "480-609-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 E OSBORN RD STE 106",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516482",
            "telephone_number": "480-609-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLUM",
        "first_name": "MIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2023-12-17",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "289029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madilyn McCall
• William McCalla III, L.AC.
• Nicole McCallister, LMSW
• Quenton McCallister
• Logan McCallum, NCC, LAC
• Jason D. McCargar, D.M.D.
• Cathleen A McCarthy, DPM
• Cole McCarthy, RBT
• Erin Lea Jeanne McCarthy, PHARM.D.
• Michael Thomas McCarthy, PH.D.

• Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2023; 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.