Kelly Marie Campbell, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11027380 Issued in FL

Practice address

2402 Frist Blvd Ste 201
Fort Pierce, FL 34950-4838

Phone

(772) 460-8838

NPI assigned

May 3, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Lawnwood Hospital Hospital, Fort Pierce, FL, CCN 100246

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kelly.campbell@hca4.eclinicaldirectplus.com

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.

• Broward Neurosurgeons LLC

  • Neurological Surgery Physician
  • Plantation, FL
  • NPI 1366499618
  NPD

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

• Lawnwood Medical Center Inc

  • General Acute Care Hospital
  • Fort Pierce, FL
  • NPI 1568409647
  Care Compare affiliation

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1114616380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 SW GOSSAMER CIR",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349901552",
            "telephone_number": "561-568-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 FRIST BLVD STE 201",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504838",
            "telephone_number": "772-460-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9267220",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11027380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cambridge 5081 LLC
• Camilla'S Touch
• Viergela Camilus, QBA
• Gina Campala, L.M.T.
• Beverly Campbell
• Richard Naugle Campbell, MS, LMHC
• Robert Dwight Campbell, MSW
• Naty Canales
• Kelly Cannon, APRN, FNP-BC
• Nicole D Canterella, PMHNP, BC

• Nurse Practitioner in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.