| Mrs Shannon Ballard Callaway, PA-C | |
|
300 W Country Club Rd Ste 130, Roswell, NM 88201-5249 | |
| (575) 625-2669 | |
| (575) 624-4632 |
| Full Name | Mrs Shannon Ballard Callaway |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 300 W Country Club Rd Ste 130, Roswell, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144224932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA2022-0043 (New Mexico) | Primary |
| 363AM0700X | Physician Assistant - Medical | COO2607 (Maryland) | Secondary |
| Entity Name | Comprehensive Rehab Consultants PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710529771 PECOS PAC ID: 6800220682 Enrollment ID: O20230227000278 |
| Entity Name | Nes Arizona Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285163121 PECOS PAC ID: 2163737206 Enrollment ID: O20230803001059 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Shannon Ballard Callaway, PA-C 300 W Country Club Rd Ste 130, Roswell, NM 88201-5249 Ph: (575) 625-2669 | Mrs Shannon Ballard Callaway, PA-C 300 W Country Club Rd Ste 130, Roswell, NM 88201-5249 Ph: (575) 625-2669 |
Mr. Sidney Clyde England, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 402 W Country Club Rd, Roswell, NM 88201 Phone: 575-627-9500 Fax: 575-627-9535 |
Tina J Southward, PAC Physician Assistant Medicare: Medicare Enrolled Practice Location: 75 Univeristy Blvd, Ste 130, Roswell, NM 88203 Phone: 575-624-7207 |
Mr. Matthew Ryan Gorman, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 405 W Country Club Rd, Roswell, NM 88201 Phone: 575-622-8170 |
Rebekah D Carlozzi, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 402 W. Country Club Rd, Roswell, NM 88201 Phone: 575-627-9500 Fax: 575-627-4127 |
John C Thomas, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 115 E 19th St, Roswell, NM 88201 Phone: 575-622-7600 Fax: 575-622-3856 |
Dawn R Korf, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N Pennsylvania Ave Ste 920, Roswell, NM 88201 Phone: 575-208-2509 Fax: 575-265-1700 |
Mr. Stephen Muhr, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 404b W College Blvd, Roswell, NM 88201 Phone: 575-291-9814 |