Campbell Medical Group, MD, PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33935 Issued in KY

Legal business name

CAMPBELL MEDICAL GROUP, MD, PSC

Practice address

303 Professional Park Dr
Glasgow, KY 42141-3487

Phone

(270) 629-3772

Fax

(270) 629-3774

NPI assigned

Sep 5, 2007

Last updated

Dec 5, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jennifer Dalton Gibson, RHIT

Title

Office Manager

Phone

(270) 629-3772

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• CAMPBELL MEDICAL GROUP Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1003000803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 PROFESSIONAL PARK DR",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413487",
            "telephone_number": "270-629-3772",
            "fax_number": "270-629-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PROFESSIONAL PARK DR",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413487",
            "telephone_number": "270-629-3772",
            "fax_number": "270-629-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL MEDICAL GROUP, MD, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "DALTON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-629-3772",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RHIT"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4716P",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "33935",
            "primary": true
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "KY",
            "license": "34221",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64095326",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000360876",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64019003",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000333249",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMPBELL MEDICAL GROUP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patricia Dawn Burton, CFM
• Sydni Paige Burton, APRN
• Clinton Bybee, PHARMD
• Kimberly Cairo, SLP
• Makayla Calhoun
• Alison S Campbell, M.D.
• Bridget Ellen Campbell, CCC,SLP
• Jason Hunter Campbell, MD
• Mallory Canter
• Cardiology Associates of Southern Kentucky PSC

• Family Medicine Physician in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.