Active NPI
Richard Charles Campbell, PH.D.
- Clinical Psychologist
- Wilmington, NC
National Provider Identifier
1124157599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1680
- Practice address
- 115 Hinton Ave
Suite 7
Wilmington, NC 28403-4785 - Phone
- (910) 350-0004
- Fax
- (910) 350-1206
- NPI assigned
- Mar 3, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1680 | NC | Primary |
| Clinical Psychologist | 103TC0700X | 550 | SC |
Addresses
Primary practice location
115 Hinton Ave
Suite 7
Wilmington, NC 28403-4785
Mailing address
115 Hinton Ave
Suite 7
Wilmington, NC 28403-4785
Phone (910) 350-0004
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61-43265 | Other | NC | UNITED BEHAVIORAL HEALTH |
| 0332J | Other | NC | BLUE CROSS BLUE SHIELD |
| 6000486 | Medicaid | NC |
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 550 | SC | MD | Clinical Psychologist |
| 550 | NC | MD | Specialist |
| 1680 | NC | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124157599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 HINTON AVE",
"address_2": "SUITE 7",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284034785",
"telephone_number": "910-350-0004",
"fax_number": "910-350-1206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 HINTON AVE",
"address_2": "SUITE 7",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284034785",
"telephone_number": "910-350-0004",
"fax_number": "910-350-1206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "RICHARD",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "1680",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "550",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "61-43265",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0332J",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000486",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.