Active NPI
James Earnest Campbell, M.D.
- Child & Adolescent Psychiatry Physician
- Glendale, AZ
National Provider Identifier
1063405629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 5458
- Practice address
- 4747 W Country Gables Dr.
Glendale, AZ 85306 - Phone
- (602) 439-2400
- Fax
- (602) 439-1414
- NPI assigned
- Aug 29, 2005
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 5458 | AZ | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 5458 | AZ | Primary |
Addresses
Primary practice location
4747 W Country Gables Dr.
Glendale, AZ 85306
Mailing address
5350 W Bell Rd.
Ste C-122 #602
Glendale, AZ 85308
Phone (602) 439-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5458 | Other | AZ | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1063405629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5350 W BELL RD.",
"address_2": "STE C-122 #602",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85308",
"telephone_number": "602-439-2400",
"fax_number": "602-439-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4747 W COUNTRY GABLES DR.",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85306",
"telephone_number": "602-439-2400",
"fax_number": "602-439-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "JAMES",
"middle_name": "EARNEST",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-29",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "5458",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "AZ",
"license": "5458",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "5458",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.