ANGELA LYNN BASHAM-CALLAWAY

Debarred entity

Born 11 Apr 1969 (57 years old),United States. Named in 4 sanctions listings.

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Summary

UPIN: H03253

Sanctions and listings4

Effective
30 Jun 2011
Official designation
Medicaid Management Information SystemUS West Virginia Medicaid Provider Exclusions and TerminationsUnited States
Excluded Indefinitely
License revoked by the WV Board of Osteopathic Medicine.
wvmmis.com
Listed
14 Jun 2013
Effective
24 May 2013
Reciprocal
OPMUS SAM Procurement ExclusionsUnited StatesActive
Prohibition/Restriction
sam.gov
Effective
18 Apr 2013
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128a4
Programme US-HHS-OIGoig.hhs.gov oig.hhs.gov
Listed
29 Apr 2013
Effective
18 Apr 2013
Reciprocal
HHSUS SAM Procurement ExclusionsUnited StatesActive
Prohibition/Restriction
Excluded by the Department of Health and Human Services pursuant to section 1128 or other sections of the Social Security Act from participation in all Federal health care programs (the scope and effect of Federal health care program exclusions is described in 42 C.F.R. section 1001.1901).
sam.gov

Positions held1

Period not retained
FAMILY PRACTICE (PHYSICIAN (MD, DO))

Identifiers1

Identifier	Number
NPI number	1124214424

Other names1

Also known as1

Angela Basham-Callaway

Addresses3

379 Stanaford Road, 310 George Street, Beckley, WV 25918
FORT WORTH, TX 76127
P O BOX 27137, #10408-088, FORT WORTH, TX 76127

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