NPIMap

Individual provider Active NPI

Jennifer Callaway

  • Emergency Medicine Physician
  • Charlotte, NC
National Provider Identifier
1902848310
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2010-00176 Issued in NC
Practice address
101 E W T Harris Blvd
Suite 5203
Charlotte, NC 28262-3485
Phone
(704) 863-9300
NPI assigned
Jun 11, 2006
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2010-00176 NC Primary

Addresses

Primary practice location

101 E W T Harris Blvd
Suite 5203
Charlotte, NC 28262-3485

Mailing address

101 E W T Harris Blvd
Charlotte, NC 28262-3485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100518000483 NC Practitioner - Emergency Medicine 3577566801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Miami, LM Miller School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

275 Hwy 16 N
Suite 202
Denver, NC 28037-3002
Phone (704) 732-9843

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 512-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue334
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2010-00176NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 6, 2016 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 6, 2016 Accepting new patients
Emergency Medicine Physicians of Iredell County, PLLC Emergency Medicine Past Accepting new patients
Winchester Emergency Medical Associates PC Emergency Medicine Past Accepting new patients

Locations

101 E Wt Harris Blvd
Charlotte, NC 28262
Phone (704) 863-0640

101 E Wt Harris Blvd
Ste 5203
Charlotte, NC 28262
Phone (704) 593-0244

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

Interoperability endpoints

  • Direct secure messaging: jcallaway136844@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1902848310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E W T HARRIS BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E W T HARRIS BLVD",
            "address_2": "SUITE 5203",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623485",
            "telephone_number": "704-863-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAWAY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2010-00176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.