Individual provider Active NPI

Tishawna Campbell

  • Specialist
  • Bronx, NY
National Provider Identifier
1023846078
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
2420 Hunter Ave Apt 11a
Bronx, NY 10475-5634
Phone
(718) 564-9444
NPI assigned
Jul 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

2420 Hunter Ave Apt 11a
Bronx, NY 10475-5634

Mailing address

2420 Hunter Ave
Bronx, NY 10475-5626
Phone (718) 564-9444

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1023846078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 HUNTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104755626",
            "telephone_number": "718-564-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 HUNTER AVE APT 11A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104755634",
            "telephone_number": "718-564-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "TISHAWNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

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

Verify at the official NPI Registry.