Individual provider Active NPI

Mary M Callahan, ARNP

  • Family Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1831151638
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3060172 Issued in FL
Practice address
1925 Mizell Ave
Suite 201
Winter Park, FL 32792-4106
Phone
(407) 628-0448
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3060172 FL Primary

Addresses

Primary practice location

1925 Mizell Ave
Suite 201
Winter Park, FL 32792-4106

Mailing address

1926 Lake Sue Dr
Orlando, FL 32803-1657
Phone (407) 252-6719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041104001167 FL Practitioner - Nurse Practitioner 5496718025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2501 N Orange Ave
Suite 200
Orlando, FL 32804-4641
Phone (407) 303-7280

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3060172FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Nov 28, 2017 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 28, 2017 Accepting new patients
Andrew J Scoma MD PA Past Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 200
Orlando, FL 32804
Phone (407) 303-7265

2501 N Orange Ave
Ste 235
Orlando, FL 32804
Phone (407) 303-1967

1925 Mizell Ave
Ste 201
Winter Park, FL 32792
Phone (407) 303-7399

200 N Lakemont Ave
Winter Park, FL 32792
Phone (407) 646-7000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mcallahan128694@adventhealth.direct-ci.com

Organizations & group practices 3

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 2

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1831151638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 LAKE SUE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031657",
            "telephone_number": "407-252-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE",
            "address_2": "SUITE 201",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924106",
            "telephone_number": "407-628-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "MARY",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3060172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.