Dannette Kallay, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

041044 Issued in GA

Practice address

1701 Boulevard SQ Ste D
Waycross, GA 31501-8022

Phone

(912) 387-0445

Fax

(912) 226-3513

NPI assigned

Oct 23, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BICIBA

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.

• Southeast Georgia Pediatrics

  • Primary Care Clinic/Center
  • Waycross, GA
  • NPI 1457613192
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1780767665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 BOULEVARD SQ STE D",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315018022",
            "telephone_number": "912-387-0445",
            "fax_number": "912-226-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 BOULEVARD SQ STE D",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315018022",
            "telephone_number": "912-387-0445",
            "fax_number": "912-226-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLAY",
        "first_name": "DANNETTE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "041044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000758491E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melony Denise Jordan
• Joshua Tree Counseling Center, LLC
• Faith Elizabeth Joyner, PA-C
• Jubilee Family Practice, LLC
• Mary A Justyn, CRNA
• Eugene Wynn Kallay, M.D.
• Kathleen M. Kallman, D.C.
• Kandallu R Ramesh, MD, PC
• Mary Kilcoyne, FNP-C
• Emilie Ann King, FNP-C

• Pediatrics Physician in Waycross, GA
• Providers in Waycross, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.