Active NPI
Kathleen Diane Campbell, M.D.
- Developmental - Behavioral Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1023549607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental - Behavioral Pediatrics Physician
- License
- MD481941
- Practice address
- 3401 Civic Center Blvd
Division of Developmental-Behavioral Pediatrics
Philadelphia, PA 19104 - Phone
- (215) 327-2736
- NPI assigned
- Mar 24, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD481941 | PA | |
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | MD481941 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Division of Developmental-Behavioral Pediatrics
Philadelphia, PA 19104
Mailing address
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 327-2736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD481941 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care Associates, Inc | Past | Accepting new patients | |
| Childrens Health Care Associates of New Jersey PC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Neonatal-Perinatal Medicine Physician
- Philadelphia, PA
- NPI 1417042466
-
- Pediatrics Physician
- Voorhees, NJ
- NPI 1427152917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1023549607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-327-2736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF DEVELOPMENTAL-BEHAVIORAL PEDIATRICS",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-327-2736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "KATHLEEN",
"middle_name": "DIANE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-24",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD481941",
"primary": false
},
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "PA",
"license": "MD481941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.