DR. MARK DAVID CALLERY (NPI# 1548246895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548246895 |
| Entity Type | Individual |
| Full Name | DR. MARK DAVID CALLERY |
| Credential | D.O. |
| Practice Address |
10512 N 110th East Ave Ste 200 Owasso OK 74055-6636 |
| Practice Telephone | 9183768900 |
| Practice Fax Number | 9183768437 |
| Mailing Telephone | 9183768900 |
| Mailing Fax Number | 9183768437 |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2014-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4179 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200037760A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437189495 | Mark P Callery | Surgery | 330 Brookline Ave, Stoneman 928, Boston, MA 02215-5400 | 2006-07-04 |
| Street Address |
10512 N 110TH EAST AVE STE 200 |
| City | OWASSO |
| State | OK |
| Zip Code | 74055-6636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265428098 | Jon Everard Orjala | Specialist | 10512 N 110th East Ave, Ste 220, Owasso, OK 74055-6638 | 2005-09-27 |
| 1043714587 | Tracy Lee Foster | Registered Nurse | 10512 N 110th East Ave, Owasso, OK 74055 | 2018-03-20 |
| 1972014439 | Elizabeth A. Tooley | Dietitian, Registered | 10512 N 110th East Ave, Owasso, OK 74055-6636 | 2017-10-23 |
| 1326468224 | Tyler Gregory Ellington | Internal Medicine | 10512 N 110th East Ave, Owasso, OK 74055-6636 | 2014-04-18 |
| 1386981413 | Karin Annette Beals | Nurse Practitioner | 10512 N 110th East Ave, Owasso, OK 74055-6636 | 2013-01-09 |
| 1275822926 | Bryan Terry Smedley | Otolaryngology | 10512 N 110th East Ave, Suite 210, Owasso, OK 74055-6636 | 2011-04-04 |
| 1528363827 | Sara Jean Enyart | Physician Assistant | 10512 N 110th East Ave, Ste 100, Owasso, OK 74055-6638 | 2011-01-18 |
| 1689802605 | Injury Prevention Solutions, Inc. | Clinic/Center | 10512 N 110th East Ave, Suite 150, Owasso, OK 74055-6636 | 2009-06-29 |
| 1477789923 | Kelly Dawn Stemm | Nurse Practitioner | 10512 N 110th East Ave, Suite 100, Owasso, OK 74055-6655 | 2009-06-10 |
| 1427233535 | Empicare, Inc. | Durable Medical Equipment & Medical Supplies | 10512 N 110th East Ave, Suite 150a, Owasso, OK 74055-6636 | 2008-01-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151587 | Lakecrest Dental-owasso 96th | Dentist | 9551 N. Owasso Expressway, Suite #100, Owasso, OK 74055 | 2019-08-27 |
| 1205328697 | Eddie Duane Gaut | Case Manager/Care Coordinator | 110 W 3rd St., Apt 11, Owasso, OK 74055 | 2018-06-01 |
| 1821586694 | Kaitlyn Konarik | Speech-Language Pathologist | 12899 E 76th St N, Ste. 109, Owasso, OH 74055 | 2018-04-27 |
| 1043733769 | Kelsey Renae Nicklas | Case Manager/Care Coordinator | 9310 N 163rd East Ave, Owasso, OK 74055 | 2017-07-25 |
| 1700259256 | Genscripts Owasso, LLC | Pharmacy | 9538 N Garnett Rd, Suite 102, Owasso, OK 74055 | 2015-11-05 |
| 1770968810 | Premier Anesthesia Management Inc | Clinic/Center | 19236 E Twin Creeks Dr, Owasso, OK 74055 | 2015-07-29 |
| 1598152407 | Justin Lum | Physical Therapist | 12326 E 86th St N, Owasso, OK 74055 | 2015-04-17 |
| 1033507660 | Kimberly Louise Howard | Physical Therapy Assistant | 12899 East 76th St North, Owasso, OK 74055 | 2015-01-06 |
| 1780920629 | Timothy Ryan Thornton | Behavioral Analyst | 11330 N 94 E Ave, Owasso, OK 74055 | 2012-12-21 |
| 1679842785 | Kelli Marie Ellis | Counselor | 19760 E Fox Run Cir, Owasso, OK 74055 | 2011-12-19 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750901682 | Robin Gail Short | Family Medicine | 9001 N 157th East Ave, Owasso, OK 74055-8545 | 2020-04-21 |
| 1548807993 | Kavanah Medical LLC | Family Medicine | 11560 N 135th East Ave, Owasso, OK 74055-5755 | 2019-12-04 |
| 1548751860 | Solidaritus Health Group PC | Family Medicine | 14601 E 88th Pl N Ste 302, Owasso, OK 74055-4966 | 2018-05-22 |
| 1336690379 | Abundant Wellness | Family Medicine | 8787 N Owasso Expy, Suite J, Owasso, OK 74055-4444 | 2016-10-14 |
| 1740648211 | Stephen R Kovacs Do Pllc | Family Medicine | 8426 N 123rd East Ave, Owasso, OK 74055-2130 | 2016-01-29 |
| 1497011563 | Samantha Phoua Vang-cheng | Family Medicine | 12455 E 100th St N Ste 190, Owasso, OK 74055-4675 | 2012-04-03 |
| 1104972629 | David L & Stanley J Smith Ptrs | Family Medicine | 8510 North 123rd East Avenue, Owasso, OK 74055 | 2007-01-26 |
| 1891850137 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 10512 N. 110th E. Ave., Owasso, OK 74055 | 2006-12-27 |
| 1891723896 | Clayton David Dejarnett | Family Medicine | 10512 North 110th East Avenue, Owasso, OK 74055-6638 | 2006-06-29 |
| 1730156340 | William E Stringer | Family Medicine | 13600 E 86th St N Ste 400, Owasso, OK 74055-8732 | 2006-03-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.