Phillip Campanella

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ01476800 Issued in NJ

Practice address

65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102

Phone

(609) 652-1000

NPI assigned

May 22, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1013609890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 STATE ROUTE 34 APT 5-8",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077471909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W JIMMIE LEEDS RD",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409102",
            "telephone_number": "609-652-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPANELLA",
        "first_name": "PHILLIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ID",
            "license": "67044",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309560-01",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01476800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Jessica Braverman, PHARMD
• Rachel Brick
• Jennifer C Brooks, PT, DPT
• Ashleigh Bry
• Pamela Ann Calime, RN, BSN, CRNFA
• Matthew Campbell, PHARM.D.
• Rommel M. Celestial, MD
• Chun W Choi, M.D.
• Kingsley Chukwueke
• Coastal Obstetrics & Gynecology Associates PA

• Adult Health Nurse Practitioner in Pomona, NJ
• Providers in Pomona, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.