Penelope Anne Campbell, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

27349 Issued in SC

Practice address

4022 Postal Way Ste C
Myrtle Beach, SC 29579-3537

Phone

(843) 903-4111

Fax

(843) 903-4242

NPI assigned

Apr 21, 2006

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

Other identifiers 3

Other names 1

• Penelope Anne Thompson Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Careteam Plus, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pawleys Island, SC
  • NPI 1902673130

  Pediatrics, SC

  Medicare reassignment NPD
• Careteam Plus, Inc.

  • Federally Qualified Health Center (FQHC)
  • Conway, SC
  • NPI 1427363209
  NPD
• Careteam Plus, Inc.

  • Specialty Pharmacy
  • Conway, SC
  • NPI 1033738133
  NPD (past)
• Charleston Carenow Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Goose Creek, SC
  • NPI 1093248288
  NPD (past)
• Conway Hospital Community Services

  • Obstetrics & Gynecology Physician
  • Conway, SC
  • NPI 1043632805
  NPD (past)
• Conway Hospital Community Services

  • Family Medicine Physician
  • Conway, SC
  • NPI 1689928103
  NPD (past)

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1124084876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50760",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295790013",
            "telephone_number": "843-903-4111",
            "fax_number": "843-903-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 POSTAL WAY STE C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793537",
            "telephone_number": "843-903-4111",
            "fax_number": "843-903-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "PENELOPE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "SC",
            "license": "27349",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "27349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "7844",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID",
            "identifier": "570783896",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4505",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENELOPE",
            "last_name": "THOMPSON",
            "middle_name": "ANNE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aris Jeannette Calhoun, MD
• Ryan Callihan, PA-C
• Steven M Callihan, MD
• Courtney Campbell, PHARMD
• Madilyn Hope Campbell, OTD
• Thomas F Campbell Jr., MA
• Jennifer Cangeme
• Marc Anthony Cannella
• Kayla Alexandria Canteen, FNP-BC
• Capeside Addiction Care, PLLC

• All providers in Myrtle Beach, SC
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.