Active NPI
Krystina E Callahan, MD
- Neurology Physician
- Charleston, SC
National Provider Identifier
1770214546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- LL88265
- Practice address
- 169 Ashley Ave
Room 202 Main Hospital Msc333
Charleston, SC 29425 - Phone
- (843) 792-3221
- NPI assigned
- Jun 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | LL88265 | SC | Primary |
Addresses
Primary practice location
169 Ashley Ave
Room 202 Main Hospital Msc333
Charleston, SC 29425
Mailing address
169 Ashley Ave
Room 202 Main Hospital Msc333
Charleston, SC 29425
Phone (843) 792-3221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221129002581 | SC | Order and Referring Only - Neurology | 9537537337 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655856000000",
"number": "1770214546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE",
"address_2": "ROOM 202 MAIN HOSPITAL MSC333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425",
"telephone_number": "843-792-3221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE",
"address_2": "ROOM 202 MAIN HOSPITAL MSC333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425",
"telephone_number": "843-792-3221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAHAN",
"first_name": "KRYSTINA",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-22",
"last_updated": "2022-06-22",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "SC",
"license": "LL88265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.