Active NPI
Shirley Campbell-Mogg, MD
- Pediatrics Physician
- Plantation, FL
National Provider Identifier
1093936668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME68933
- Practice address
- 4101 NW 4TH Street
Suite 200
Plantation, FL 33317-2839 - Phone
- (954) 791-5420
- Fax
- (954) 791-5950
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME68933 | FL | Primary |
Addresses
Primary practice location
4101 NW 4TH Street
Suite 200
Plantation, FL 33317-2839
Mailing address
4101 NW 4TH St
Suite 200
Plantation, FL 33317-2850
Phone (954) 791-5420
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 378403700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME68933 | FL | MD | Pediatrics Physician |
Interoperability endpoints
- drmogg@direct.meditouchehr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455667200000",
"number": "1093936668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 NW 4TH ST",
"address_2": "SUITE 200",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333172850",
"telephone_number": "954-791-5420",
"fax_number": "954-791-5950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 NW 4TH STREET",
"address_2": "SUITE 200",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333172839",
"telephone_number": "954-791-5420",
"fax_number": "954-791-5950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL-MOGG",
"first_name": "SHIRLEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2016-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME68933",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "378403700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.