NPIMap

Individual provider Active NPI

Russell Witter Campbell, MD

  • Vascular Surgery Physician
  • Williamsburg, VA
National Provider Identifier
1104880160
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0101046591 Issued in VA
Practice address
156 Strawberry Plains Rd
Suite a
Williamsburg, VA 23188-3409
Phone
(757) 229-7939
Fax
(757) 229-7897
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 51819 MT
Vascular Surgery Physician 2086S0129X 0101046591 VA Primary

Addresses

Primary practice location

156 Strawberry Plains Rd
Suite a
Williamsburg, VA 23188-3409

Mailing address

856 J Clyde Morris Blvd
Suite a
Newport News, VA 23601-1318

Other practice location 1

500 J Clyde Morris Blvd Ste 603
Newport News, VA 23601-1929
Phone (757) 534-5340

Other practice location 2

500 W Broadway St Ste 320
Missoula, MT 59802-4003
Phone (406) 329-5615

Other practice location 3

1333 Surgical Services Way
Kalispell, MT 59901-4844
Phone (406) 751-5392

Other identifiers 1

IdentifierTypeStateIssuer
1104880160MedicaidVA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rcampbell1200841@wm.providencedirect.org Direct
Direct Messaging Address DEPTLHREVIntegrityHIMTechs@logan.org Kalispell Regional Medical Center, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109001085 VA Practitioner - Vascular SurgeryPractitioner - Peripheral Vascular Disease 7618920380 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Rutgers, Robert Woood Johnson Medical School, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1937 Thomson Dr
Lynchburg, VA 24501-1008

Hospital & facility affiliations

  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51819MTMDVascular Surgery Physician
0101046591VAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Oct 27, 2023 Accepting new patients
Winchester Medical Center Current Accepting new patients
Valley Physician Enterprise, Inc Vascular Surgery Current Accepting new patients
Centra Medical Group, LLC CurrentSince May 12, 2015 Accepting new patients
Valley Physician Enterprise Inc CurrentSince Oct 27, 2023 Accepting new patients
Valley Physician Enterprise, Inc. CurrentSince Oct 27, 2023 Accepting new patients
Winchester Medical Center, Inc. CurrentSince Oct 27, 2023 Accepting new patients
Centra Health Professional Services, LLC CurrentSince May 12, 2015 Accepting new patients

Locations

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6965

2410 Atherholt Rd
Lynchburg, VA 24501
Phone (434) 200-5252

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

1880 Amherst St
Ste 300
Winchester, VA 22601
Phone (540) 536-6721

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Interoperability endpoints

  • FHIR API: https://epicproxy.et1320.epichosted.com/FHIRProxy/api/FHIR/R4
  • Direct secure messaging: rcampbell1200841@wm.providencedirect.org
  • Direct secure messaging: rcampbell1162123@valleyhealth.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1104880160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 STRAWBERRY PLAINS RD",
            "address_2": "SUITE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231883409",
            "telephone_number": "757-229-7939",
            "fax_number": "757-229-7897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 J Clyde Morris Blvd Ste 603",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236011929",
            "country_code": "US",
            "telephone_number": "757-534-5340",
            "fax_number": "757-594-3456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 W Broadway St Ste 320",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024003",
            "country_code": "US",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-2791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1333 Surgical Services Way",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599014844",
            "country_code": "US",
            "telephone_number": "406-751-5392",
            "fax_number": "406-751-5406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "RUSSELL",
        "middle_name": "WITTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MT",
            "license": "51819",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101046591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104880160",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcampbell1200841@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 W Broadway St Ste 320",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598024003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DEPTLHREVIntegrityHIMTechs@logan.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "address_1": "1333 Surgical Services Way",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599014844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.