Individual provider Active NPI

Cammy D Campbell, ARNP

  • Primary Care Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1093254252
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN9296699 Issued in FL
Practice address
1111 W Fairbanks Ave Ste 200
Winter Park, FL 32789-4777
Phone
(407) 635-5543
Fax
(321) 842-4002
NPI assigned
Feb 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN9296699 FL
Family Nurse Practitioner 363LF0000X ARNP9296699 FL
Family Nurse Practitioner 363LF0000X AP135096 TX
Primary Care Nurse Practitioner 363LP2300X APRN9296699 FL Primary

Addresses

Primary practice location

1111 W Fairbanks Ave Ste 200
Winter Park, FL 32789-4777

Mailing address

1111 W Fairbanks Ave Ste 200
Winter Park, FL 32789-4777
Phone (407) 635-5543

Other practice location 1

52 W Underwood St
Orlando, FL 32806-1110
Phone (888) 912-3648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170407001907 FL Practitioner - Nurse Practitioner 7618253550 Reassigns benefits to 3 organizations
I20171115000676 TX Practitioner - Nurse Practitioner 7618253550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

1111 W Fairbanks Ave
Suite 200
Winter Park, FL 32789-4777
Phone (407) 635-5516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9296699FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Apr 15, 2020 Accepting new patients
Orlando Physicians Network Inc CurrentSince Jan 3, 2024 Accepting new patients
Copilotiq, PC CurrentSince Dec 19, 2022 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 15, 2020 Accepting new patients

Locations

6271 Saint Augustine Rd
Jacksonville, FL 32217
Phone (615) 412-8777

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

86 Underwood St
Orlando, FL 32806
Phone (321) 841-5142

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1111 W Fairbanks Ave
Ste 200
Winter Park, FL 32789
Phone (407) 635-3024

600 12th Ave S
Apt 1000
Nashville, TN 37203
Phone (615) 412-8777

1910 Pacific Ave
Ste 2000
Dallas, TX 75201
Phone (615) 412-8777

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22351/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1093254252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W FAIRBANKS AVE STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894777",
            "telephone_number": "407-635-5543",
            "fax_number": "321-842-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W FAIRBANKS AVE STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894777",
            "telephone_number": "407-635-5543",
            "fax_number": "321-842-4002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 W Underwood St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061110",
            "country_code": "US",
            "telephone_number": "888-912-3648",
            "fax_number": "321-841-4085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CAMMY",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-20",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9296699",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9296699",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135096",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN9296699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.