Individual provider Active NPI

Barbara Kane Campbell, PH.D.

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1124199385
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
560 Issued in OR
Practice address
1942 NW Kearney St
Suite 24
Portland, OR 97209-1426
Phone
(503) 227-3932
Fax
(503) 636-8784
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 560 OR Primary

Addresses

Primary practice location

1942 NW Kearney St
Suite 24
Portland, OR 97209-1426

Mailing address

1942 NW Kearney St
Ste 24
Portland, OR 97209-1465
Phone (503) 221-7074

Other identifiers 1

IdentifierTypeStateIssuer
560OtherORPSYCHOLOGIST LICENSE

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

LicenseStateTypeSpecialty
560ORMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1124199385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 NW KEARNEY ST",
            "address_2": "STE 24",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091465",
            "telephone_number": "503-221-7074",
            "fax_number": "503-636-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 NW KEARNEY ST",
            "address_2": "SUITE 24",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091426",
            "telephone_number": "503-227-3932",
            "fax_number": "503-636-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "BARBARA",
        "middle_name": "KANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE",
            "identifier": "560",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.