Rafael Espique Callanta, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

001503 Issued in NV

Practice address

601 S Rancho Dr Ste A6
Las Vegas, NV 89106-4898

Phone

(702) 386-0909

Fax

(702) 386-0707

NPI assigned

Mar 11, 2013

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

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: med-careproviders.rafaelcallanta160081.advancedmd-direct.com@160081.advancedmd-direct.com
• Direct secure messaging: rafael.callanta@asapc-nv.direct.office.nextgen.com

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.

• Eddiepmd Inc

  • Physical Medicine & Rehabilitation Physician
  • Las Vegas, NV
  • NPI 1306934443
  Medicare reassignment
• Primary Care Providers of Southern Nevada LLC

  • Primary Care Nurse Practitioner
  • Las Vegas, NV
  • NPI 1750006078
  NPD
• Silver Healthcare Solutions LLC

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1487197091
  NPD (past)

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1881935237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 HUNT ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461443",
            "telephone_number": "702-498-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S RANCHO DR STE A6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064898",
            "telephone_number": "702-386-0909",
            "fax_number": "702-386-0707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3750 S Jones Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891032209",
            "country_code": "US",
            "telephone_number": "702-444-7744",
            "fax_number": "702-444-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLANTA",
        "first_name": "RAFAEL",
        "middle_name": "ESPIQUE",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-11",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "700891",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "001503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Callahan
• Matilda Callahan
• Nadine Callahan
• Danielle Marie Callanan, PA-C
• Alexandra Louisse Panganiban Callanta, FNP-C
• Callaway-Nelson Centennial Modern Dentistry, PC
• Callaway-Nelson Flamingo Smiles, PC
• Cari Allison Callaway-Nelson, DDS
• Donna Renee Callaway, D.C.
• Randall Callaway, M.S., MFT

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.