Kristin J. Campos, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.003697 Issued in OH

Practice address

5901 Monclova Rd
Maumee, OH 43537-1841

Phone

(419) 893-5968

Fax

(419) 893-5969

NPI assigned

Apr 29, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcampos7884@direct.promedica.org

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.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150

  Physician Assistant

  Medicare reassignment NPD
• Promedica Central Physicians

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1104260520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371841",
            "telephone_number": "419-893-5968",
            "fax_number": "419-893-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371841",
            "telephone_number": "419-893-5968",
            "fax_number": "419-893-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "KRISTIN",
        "middle_name": "J.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcampos7884@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alicia A Cales, L.M.T.
• Cambridge Home Health Care, Inc.
• Erica Campbell, AUD
• Jodi Campbell, LPN
• Marlena Campbell, RBT
• Kantrell Youzan Cantlope
• Michael David Cardinal, DPM
• Careline Hoh100 LLC
• Careline Poh100 LLC
• Joellen M Carey, COTA/L

• Physician Assistant in Maumee, OH
• Providers in Maumee, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.