NPIMap

Organization Active NPI

Kelli K McCallum

  • Primary Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1831508829
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
R177915 Issued in MD
Legal business name
KELLI K MCCALLUM
Practice address
3721 Chesmont Ave
Baltimore, MD 21206-5041
Phone
(443) 600-0105
NPI assigned
Aug 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Authorized official

Name
Mrs. Kelli McCallum, CRNP
Title
Nurse Practitioner
Phone
(443) 600-0105

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X R177915 MD
Primary Care Clinic/Center 261QP2300X R177915 MD Primary

Addresses

Primary practice location

3721 Chesmont Ave
Baltimore, MD 21206-5041

Mailing address

3721 Chesmont Ave
Baltimore, MD 21206-5041
Phone (443) 600-0105

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1831508829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 CHESMONT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065041",
            "telephone_number": "443-600-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 CHESMONT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065041",
            "telephone_number": "443-600-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLI K MCCALLUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "MCCALLUM",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "443-600-0105",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MD",
            "license": "R177915",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "R177915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.