Individual provider Active NPI

Callie Paige Leaman

  • Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1790377836
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704320979 Issued in MI
Practice address
1105 Sixth St
Traverse City, MI 49684-2345
Phone
(231) 935-5000
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704320979 MI Primary

Addresses

Primary practice location

1105 Sixth St
Traverse City, MI 49684-2345

Mailing address

1105 Sixth St Ste 300
Traverse City, MI 49684-2345
Phone (231) 392-0640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20210331000843 MI Practitioner - Nurse Practitioner 7214344662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1221 6TH St
Traverse City, MI 49684-2701
Phone (231) 392-0643

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704320979MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Current Accepting new patients
Munson Medical Center CurrentSince May 1, 2021 Accepting new patients
Munson Medical Center CurrentSince May 1, 2021 Accepting new patients
Munson Medical Center Past Accepting new patients
Munson Medical Center PastSince Mar 16, 2021 Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

1221 Sixth St
Ste 300
Traverse City, MI 49684
Phone (231) 392-0640

1221 Sixth St
Traverse City, MI 49684
Phone (231) 392-0640

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

1105 Sixth St
Ste 300
Traverse City, MI 49684
Phone (231) 935-2400

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Interoperability endpoints

  • Direct secure messaging: cleaman@direct.mhc.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1790377836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST STE 300",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-392-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAMAN",
        "first_name": "CALLIE",
        "middle_name": "PAIGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704320979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.