Charles Allen Callaway, R.PH, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001074 Issued in GA

Practice address

2120 Highway 76 Ste a
Cohutta Place
Chatsworth, GA 30705-7302

Phone

(706) 695-0107

Fax

(706) 517-9633

NPI assigned

Feb 9, 2007

Sex

Male

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 3

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Pharmacist

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• NW Georgia Eye Care

  • Optometrist
  • Chatsworth, GA
  • NPI 1689833089
  Authorized official Same address or phone

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1821139080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 HIGHWAY 76 STE A",
            "address_2": "COHUTTA PLACE PLAZA",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307057302",
            "telephone_number": "706-695-0107",
            "fax_number": "706-517-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 HIGHWAY 76 STE A",
            "address_2": "COHUTTA PLACE",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307057302",
            "telephone_number": "706-695-0107",
            "fax_number": "706-517-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAWAY",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "R.PH, O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001074",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH012110",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NPI",
            "identifier": "1689833089",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000667664A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER PTAN",
            "identifier": "511G700552",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles C Burke, M. D.
• C-Worth Family Walk-in Clinic
• C-Worth Family Walk-in Clinic
• C-Worth Family Walk-in Clinic, LLC
• Macie Rebekah Cable
• Jesus E Camacho
• Mary Kendra Carter, RN
• Tucker Oliver Champeau, PT, DPT
• Chatsworth Family Dentistry, PC
• Chatsworth Health Care Center, Inc.

• Optometrist in Chatsworth, GA
• Providers in Chatsworth, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.