Individual provider Active NPI

William Egbert Campbell Jr., MD

  • Diagnostic Radiology Physician
  • Charlotte, NC
National Provider Identifier
1043299175
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
31965 Issued in NC
Practice address
700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone
(704) 334-7800
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 31965 NC
Diagnostic Radiology Physician 2085R0202X 31965 NC Primary

Addresses

Primary practice location

700 E Morehead St Ste 300
Charlotte, NC 28202-2742

Mailing address

700 E Morehead St Ste 300
Charlotte, NC 28202-2742

Other practice location 1

222 N Lafayette St
Suite 01
Shelby, NC 28150-4450
Phone (704) 482-3880

Other identifiers 6

IdentifierTypeStateIssuer
8920986MedicaidNC
18881OtherSCSC MEDICAL LICENSE
20986OtherNCNC BLUE CROSS BLUE SHIELD
31965OtherNCN MEDICAL LICENSE
MD030659OtherPAPA MEDICAL LICENSE
N31965MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101023000265 NC Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8921994302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Wake Forest University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

724 Aubrey Bell Dr
Matthews, NC 28105-5055
Phone (704) 295-3550

Hospital & facility affiliations

  • Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31965NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Medical Services LLC Diagnostic Radiology CurrentSince Apr 18, 2023 Accepting new patients
Charlotte Radiology P a CurrentSince Feb 1, 2023 Accepting new patients
Carolinas Imaging Services, LLC CurrentSince Nov 1, 2024 Accepting new patients
Wake Forest Health Network, LLC Past Accepting new patients
High Point Radiological Services Diagnostic Radiology Past Accepting new patients

Locations

12335 N Community House Rd
Ste B
Charlotte, NC 28277

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

724 Aubrey Bell Dr
Matthews, NC 28105
Phone (704) 295-3550

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1043299175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 N Lafayette St",
            "address_2": "Suite 01",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281504450",
            "country_code": "US",
            "telephone_number": "704-482-3880",
            "fax_number": "704-487-0294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "WILLIAM",
        "middle_name": "EGBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NC",
            "license": "31965",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "31965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8920986",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MEDICAL LICENSE",
            "identifier": "18881",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BLUE CROSS BLUE SHIELD",
            "identifier": "20986",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N MEDICAL LICENSE",
            "identifier": "31965",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICAL LICENSE",
            "identifier": "MD030659",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N31965",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.