Active NPI
Brian L Campbell, PTA
- Physical Therapy Assistant
- Knoxville, TN
National Provider Identifier
1104292481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2874
- Practice address
- 8904 Cross Park Dr
Knoxville, TN 37923-4703 - Phone
- (865) 690-2671
- Fax
- (865) 690-6445
- NPI assigned
- Aug 20, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2874 | TN | Primary |
Addresses
Primary practice location
8904 Cross Park Dr
Knoxville, TN 37923-4703
Mailing address
8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-8930
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2874 | TN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440028800000",
"number": "1104292481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8823 PRODUCTION LN",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373636511",
"telephone_number": "423-238-8930",
"fax_number": "423-285-6647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8904 CROSS PARK DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379234703",
"telephone_number": "865-690-2671",
"fax_number": "865-690-6445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "BRIAN",
"middle_name": "L",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-20",
"last_updated": "2015-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "2874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.