Individual provider Active NPI

Brian A Campbell, DC

  • Chiropractor
  • West Palm Beach, FL
National Provider Identifier
1073519096
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6314 Issued in FL
Practice address
1025 N Congress Ave
West Palm Beach, FL 33409-5144
Phone
(561) 689-2900
Fax
(561) 689-1964
NPI assigned
Jun 23, 2005
Last updated
Jul 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6314 FL Primary

Addresses

Primary practice location

1025 N Congress Ave
West Palm Beach, FL 33409-5144

Mailing address

1025 N Congress Ave
West Palm Beach, FL 33409-5144
Phone (561) 689-2900

Other identifiers 1

IdentifierTypeStateIssuer
380610300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060426000136 FL Practitioner - Chiropractic 5597775205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1025 N Congress Ave
West Palm Beach, FL 33409-5144

8409 N Military Trail
Suite 113
Palm Beach Gardens, FL 33410-6321
Phone (561) 630-9495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Health Inc Chiropractor CurrentSince Dec 31, 1991 Accepting new patients
Campbell Sports Rehab Inc Chiropractor CurrentSince Aug 10, 2004 Accepting new patients

Locations

1025 N Congress Ave
West Palm Beach, FL 33409
Phone (561) 684-9200

8409 N Military Trl
Ste 113
West Palm Beach, FL 33410
Phone (561) 402-4701

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.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1073519096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N CONGRESS AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334095144",
            "telephone_number": "561-689-2900",
            "fax_number": "561-689-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N CONGRESS AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334095144",
            "telephone_number": "561-689-2900",
            "fax_number": "561-689-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380610300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.