Individual provider Active NPI

Roosevelt V Campbell, MD

  • General Practice Physician
  • Weslaco, TX
National Provider Identifier
1073046447
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
T3594 Issued in TX
Practice address
1001 St. James St
Weslaco, TX 78596
Phone
(956) 647-8600
Fax
(956) 969-9564
NPI assigned
Apr 4, 2017
Last updated
Jul 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X T3594 TX Primary

Addresses

Primary practice location

1001 St. James St
Weslaco, TX 78596

Mailing address

1001 St. James St
Weslaco, TX 78596
Phone (956) 647-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211214002473 TX Practitioner - Family Practice 1153711726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

1001 James St
Weslaco, TX 78596-0008
Phone (956) 647-8600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T3594TXMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Jun 5, 2023 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Jun 5, 2023 Accepting new patients

Locations

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

1001 James St
Weslaco, TX 78596
Phone (956) 647-8600

Interoperability endpoints

  • Direct secure messaging: roosevelt.campbell@wellmed.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1073046447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ST. JAMES ST",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "78596",
            "telephone_number": "956-647-8600",
            "fax_number": "956-969-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ST. JAMES ST",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "78596",
            "telephone_number": "956-647-8600",
            "fax_number": "956-969-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ROOSEVELT",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "T3594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weslaco, TX

Sources for this page

Verify at the official NPI Registry.