Roscoe Callaway, CONTRACTOR

Primary specialty

ContractorTaxonomy code 171W00000X

License

2705158786 Issued in VA

Practice address

1121 Campostella Rd
Norfolk, VA 23523-2103

Phone

(757) 543-0843

Fax

(757) 543-0504

NPI assigned

Dec 11, 2019

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 11, 2019.

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1821636788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 CAMPOSTELLA RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235232103",
            "telephone_number": "757-543-0843",
            "fax_number": "757-543-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 CAMPOSTELLA RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235232103",
            "telephone_number": "757-543-0843",
            "fax_number": "757-543-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAWAY",
        "first_name": "ROSCOE",
        "credential": "CONTRACTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "VA",
            "license": "2705158786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Corinne Calisch, PSY.D.
• Angelo Medina Calivoso, MSO
• Michael Hutchinson Call, M.S.,ATC,CSCS
• William E. Callaghan, M.D.
• Linda Brede Callahan, RN, IBCLC
• Milana-Thai Caira Calupitan
• Stephanie Nora Camacho, NNP-BC
• Camellia House LLC
• Jessica Cameron
• Robert Michael Camp, MD

• All providers in Norfolk, VA
• Contractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.