NPIMap

Organization Active NPI

McCallum Orthodontics PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Greenwood, SC
National Provider Identifier
1891847968
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
SC ORTHO 448 Issued in SC
Legal business name
MCCALLUM ORTHODONTICS PA
Practice address
608 Calhoun Ave
Greenwood, SC 29649
Phone
(864) 229-1611
NPI assigned
Jan 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ernest J McCallum, DDSNPI 1649495953
Title
President
Phone
(864) 229-1601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X SC ORTHO 448 SC Primary

Addresses

Primary practice location

608 Calhoun Ave
Greenwood, SC 29649

Mailing address

608 Calhoun Ave
Greenwood, SC 29649
Phone (864) 229-1611

Other identifiers 2

IdentifierTypeStateIssuer
ZA9640OtherGROUP MEDICAID
ZX3175MedicaidSC

National Provider Directory

National Provider Directory

Locations

608 Calhoun Ave
Greenwood, SC 29649
Phone (864) 229-1611

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891847968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 CALHOUN AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29649",
            "telephone_number": "864-229-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 CALHOUN AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29649",
            "telephone_number": "864-229-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCALLUM ORTHODONTICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCALLUM",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-229-1601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SC",
            "license": "SC ORTHO 448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "ZA9640",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3175",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.