Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeremiah Callahan

Individual provider Family Nurse Practitioner · NPI 1144186024

Jeremiah Callahan is a Nurse Practitioner in Gilbert, Arizona. Qualified in 2025, 1 year ago. Practices with Banner - University Super Specialists LLC, a 32-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
1
Licensed in
AZ
In the registry since
2026
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Practice location Address checks out

3590 S Ponderosa Dr
Gilbert, AZ 85297-7714
Phone: (520) 349-2261
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 221161 (AZ)

Record details

NPI number1144186024
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 5, 2026
Last updated in NPPESJanuary 5, 2026
Certification dateJanuary 4, 2026
Mailing address3590 S Ponderosa Dr, Gilbert, AZ 85297-7714

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Banner - University Super Specialists Llc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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