Eloise Campbell, NP,CDE,BC-ADM

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

3003087 Issued in KY

Practice address

920 Dupont Rd
Louisville, KY 40207-4692

Phone

(502) 895-2334

Fax

(502) 896-6987

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Diabetes Resource Center, Inc

  • Durable Medical Equipment & Medical Supplies
  • Louisville, KY
  • NPI 1356398929
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1053474262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 BREAUX DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402202113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DUPONT RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074692",
            "telephone_number": "502-895-2334",
            "fax_number": "502-896-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ELOISE",
        "credential": "NP,CDE,BC-ADM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "3003087",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71001251A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3003087",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "71001251A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryah Campbell, LCSW
• Carol Campbell, P.T.
• Cayla Campbell
• Debbie L Campbell, M.A.
• Dena Lashayne Campbell, OTR/L
• Jane Campbell
• Jean Amos Campbell, LMFT
• Keisha Nicole Campbell
• Lisa Campbell, LCSW
• Lisa C Campbell, LPT

• Adult Health Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Adult Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.