Cory Callahan, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5089 Issued in TN

Practice address

410 N State of Franklin Rd Ste 140
Johnson City, TN 37604-6972

Phone

(423) 431-2460

NPI assigned

Feb 7, 2017

Last updated

Feb 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ccallahan309216@balladhealth.medalliesdirect.net

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.

• Wellmont Medical Associates Inc

  dba Ballad Health Medical Associates

  • Pulmonary Disease Physician
  • Bristol, TN
  • NPI 1780986257
  Medicare reassignment Care Compare group
• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1760405849
  NPD
• Wellmont Medical Associates, Inc.

  dba Ballad Health Medical Associates

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Cardiovascular Disease Physician
  • Johnson City, TN
  • NPI 1740227131

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain States Health Alliance

  dba Woodridge Hospital

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1023434339
  Care Compare affiliation
• Mountain States Health Alliance

  dba Johnson City Medical Center

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1962915652
  Care Compare affiliation
• Mountain States Health Alliance

  dba Johnson City Medical Center

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1972606465
  Care Compare affiliation

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1932647112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD STE 140",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046972",
            "telephone_number": "423-431-2460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 State St, Suite 340",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "04401",
            "country_code": "US",
            "telephone_number": "207-973-4949",
            "fax_number": "207-973-4466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "378 Marketplace Blvd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042361",
            "country_code": "US",
            "telephone_number": "423-282-0751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "CORY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-07",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1675",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5089",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "5089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccallahan309216@balladhealth.medalliesdirect.net",
            "affiliation": "Y",
            "endpointDescription": "Ballad Health Care Everywhere",
            "affiliationName": "Wellmont Medical Associates Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "105 W Stone Dr",
            "address_2": "Suite 6A",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alicia Merie Caffrey
• Matthew John Caffrey, MD/MPH
• Whitley Cagle, OD
• Heather Michele Calhoun, RBT
• Rachel Call, MSOT, OTR/L
• Faith C Cambron Morelock
• Alayna Marie Cameron, MD
• Angela R Cameron, D.D.S.
• Campbell Clinic PC
• Audrey L Campbell, DO

• Surgical Physician Assistant in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Surgical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.