Individual provider Active NPI

Sharon L Campbell, ARNP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1124182514
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN121520 Issued in GA
Practice address
1188 Ralph David Abernathy Blvd West End
Atlanta, GA 30310-1716
Phone
(404) 755-0570
Fax
(404) 755-0520
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN121520 GA Primary

Addresses

Primary practice location

1188 Ralph David Abernathy Blvd West End
Atlanta, GA 30310-1716

Mailing address

10051 5TH Street North #200
St. Petersburg, FL 33702-2211
Phone (404) 755-8996

Other identifiers 1

IdentifierTypeStateIssuer
978833161AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041208000536 GA Practitioner - Nurse Practitioner 0143286542 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Clinic, PC CurrentSince Jan 1, 2017 Accepting new patients

Locations

1188 Ralph David Abernathy Blvd SW
Atlanta, GA 30310
Phone (404) 755-8996

1861 Peeler Rd
Ste 100
Dunwoody, GA 30338
Phone (770) 730-5800

6330 Primrose Hill Ct
Peachtree Corners, GA 30092
Phone (770) 309-8108

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1124182514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH STREET NORTH #200",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337022211",
            "telephone_number": "404-755-8996",
            "fax_number": "404-755-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 RALPH DAVID ABERNATHY BLVD WEST END",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101716",
            "telephone_number": "404-755-0570",
            "fax_number": "404-755-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SHARON",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN121520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "978833161A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.