Active NPI
Karen Marie Callockio
- Speech-Language Pathologist
- Jackson, MI
National Provider Identifier
1942578034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12152440
- Practice address
- 2100 Park Rd
Jackson, MI 49203-4938 - Phone
- (517) 782-8888
- NPI assigned
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 12152440 | MI | Primary |
Addresses
Primary practice location
2100 Park Rd
Jackson, MI 49203-4938
Mailing address
2100 Park Rd
Jackson, MI 49203-4938
Phone (517) 782-8888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12152440 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323129600000",
"number": "1942578034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 PARK RD",
"city": "JACKSON",
"state": "MI",
"postal_code": "492034938",
"telephone_number": "517-782-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 PARK RD",
"city": "JACKSON",
"state": "MI",
"postal_code": "492034938",
"telephone_number": "517-782-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLOCKIO",
"first_name": "KAREN",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-05",
"last_updated": "2011-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "12152440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.