Brian Scott Callahan, O.D.
Individual provider Active NPI Optometrist · Pearl, MS
NPI 1992839088 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992839088
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 590 (MS)
- Practice address
- 5520 Highway 80 E
Pearl, MS 39208-8926 - Phone
- (601) 932-1890
- Fax
- (601) 932-3119
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5520 Hwy 80 E
Pearl, MS 39208-8926
Phone (601) 932-1890
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081014000228 | MS | Practitioner - Optometry | 3870661119 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian S Callahan O.D. Inc. | Optometrist | Current |
Accepting new patients |
Locations
5520 Highway 80 E
Pearl, MS 39208
Phone (601) 932-1890
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 590 | MS | Yes |
Addresses
Primary practice location
5520 Highway 80 E
Pearl, MS 39208-8926
Mailing address
5520 Highway 80 E
Pearl, MS 39208-8926
Phone (601) 932-1890
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07321 | Other | MS | SPECTERA |
| 03755233 | Medicaid | MS |
Other providers in Pearl, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.