Individual provider Active NPI

Alan Carl Campbell, PH.D.

  • Marriage & Family Therapist
  • Stillwater, OK
National Provider Identifier
1083716641
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
652 Issued in OK
Practice address
2222 W 12TH Ave
Stillwater, OK 74074-5154
Phone
(405) 372-1988
Fax
(405) 624-1988
NPI assigned
Sep 3, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 589 OK
Marriage & Family Therapist 106H00000X 652 OK Primary

Addresses

Primary practice location

2222 W 12TH Ave
Stillwater, OK 74074-5154

Mailing address

2222 W 12TH Ave
Stillwater, OK 74074-5154
Phone (405) 372-1988

Other identifiers 1

IdentifierTypeStateIssuer
100841380AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000916 OK Practitioner - Clinical Psychologist 0840475794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

406 E Hall of Fame Ave
Suite 300
Stillwater, OK 74075-5447
Phone (405) 533-8612

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
652OKMDClinical Psychologist
589OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority CurrentSince Dec 17, 2021 Accepting new patients
Stillwater Medical Center Authority CurrentSince Dec 17, 2021 Accepting new patients

Locations

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

2220 W 7th Ave
Stillwater, OK 74074
Phone (405) 372-1988

406 E Hall of Fame Ave
Ste 300
Stillwater, OK 74075
Phone (405) 533-8612

Interoperability endpoints

  • Direct secure messaging: alan.campbell.p1@direct.smc.nextgenshare.com

Organizations & group practices 3

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": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1083716641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W 12TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740745154",
            "telephone_number": "405-372-1988",
            "fax_number": "405-624-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W 12TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740745154",
            "telephone_number": "405-372-1988",
            "fax_number": "405-624-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ALAN",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OK",
            "license": "589",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100841380A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.