Organization Active NPI

David Campbell

  • Vascular Surgery Physician
  • Boston, MA
National Provider Identifier
1063477446
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
39971 Issued in MA
Legal business name
DAVID CAMPBELL
Practice address
110 Francis St
Suite 5C
Boston, MA 02215-5501
Phone
(617) 632-9848
Fax
(617) 632-7794
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Authorized official

Name
David R Campbell, M.D.
Title
MD/Owner
Phone
(617) 632-9848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 39971 MA Primary

Addresses

Primary practice location

110 Francis St
Suite 5C
Boston, MA 02215-5501

Mailing address

PO Box 86
Hingham, MA 02043-0086
Phone (781) 749-9071

Other identifiers 4

IdentifierTypeStateIssuer
0092648OtherMAAE/US
A27717BIOtherMAHPHC
0194964MedicaidMA
030545OtherMATUFTS

National Provider Directory

National Provider Directory

Locations

110 Francis St
Ste 5C
Boston, MA 02215
Phone (617) 632-9848

25 Highland Ave
Ste 9
Newburyport, MA 01950
Phone (617) 632-9848

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413244800000",
    "number": "1063477446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020430086",
            "telephone_number": "781-749-9071",
            "fax_number": "781-749-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST",
            "address_2": "SUITE 5C",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "617-632-9848",
            "fax_number": "617-632-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID CAMPBELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2014-10-14",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "617-632-9848",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "39971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AE/US",
            "identifier": "0092648",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "A27717BI",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0194964",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "030545",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.