Organization Active NPI

James R. Campbell, D.O., Inc.

  • Primary Care Clinic/Center
  • Broken Arrow, OK
National Provider Identifier
1053507574
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
1880 Issued in OK
Legal business name
JAMES R. CAMPBELL, D.O., INC.
Practice address
500 S Elm PL
Broken Arrow, OK 74012-5325
Phone
(918) 251-1391
Fax
(918) 251-3008
NPI assigned
Sep 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
James R. Campbell, D.O.NPI 1720091077
Title
President
Phone
(918) 251-1391

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 1880 OK
Primary Care Clinic/Center 261QP2300X 1880 OK Primary

Addresses

Primary practice location

500 S Elm PL
Broken Arrow, OK 74012-5325

Mailing address

500 S Elm PL
Broken Arrow, OK 74012-5325
Phone (918) 251-1391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080512000771 OK Part B Supplier - Clinic/Group Practice 7315026135 Receives reassigned benefits from 2 practitioners
Practice locations: Broken Arrow, OK

National Provider Directory

National Provider Directory

Locations

500 S Elm Pl
Broken Arrow, OK 74012
Phone (918) 251-1391

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1053507574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125325",
            "telephone_number": "918-251-1391",
            "fax_number": "918-251-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125325",
            "telephone_number": "918-251-1391",
            "fax_number": "918-251-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES R. CAMPBELL, D.O., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-251-1391",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OK",
            "license": "1880",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OK",
            "license": "1880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.