Active NPI
Vern J Campbell, M.D.
- Ophthalmology Physician
- Petoskey, MI
National Provider Identifier
1114963766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- VC059657
- Practice address
- 932 Spring St
Suite 101
Petoskey, MI 49770-2855 - Phone
- (231) 487-5315
- NPI assigned
- Jun 21, 2006
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | VC059657 | MI | Primary |
Addresses
Primary practice location
932 Spring St
Suite 101
Petoskey, MI 49770-2855
Mailing address
932 Spring St
Suite 101
Petoskey, MI 49770-2855
Phone (231) 487-5315
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4549885 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VC059657 | MI | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1114963766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "932 SPRING ST",
"address_2": "SUITE 101",
"city": "PETOSKEY",
"state": "MI",
"postal_code": "497702855",
"telephone_number": "231-487-5315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "932 SPRING ST",
"address_2": "SUITE 101",
"city": "PETOSKEY",
"state": "MI",
"postal_code": "497702855",
"telephone_number": "231-487-5315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "VERN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MI",
"license": "VC059657",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4549885",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Petoskey, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.