Lance Mathew Campbell, DHSC, MSCPT, MTC
Individual provider Active NPI Orthopedic Physical Therapist · Callaway, FL
NPI 1124304027 · NPPES record last updated Oct 25, 2011
Key facts
- NPI
- 1124304027
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 9759 (FL)
- Practice address
- 807 N Tyndall Pkwy
Callaway, FL 32404-9495 - Phone
- (850) 819-1937
- NPI assigned
- Oct 25, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Excel Therapy, LLC
Practice addresses (Care Compare)
3420 E 15TH St
Panama City, FL 32405-7425
Phone (850) 215-8844
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120131000659 | FL | Practitioner - Physical Therapist in Private Practice | 6002082633 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Excel Therapy, LLC | Geriatrics | Current |
Accepting new patients |
Locations
3420 E 15th St
Panama City, FL 32405
Phone (850) 215-8844
807 N Tyndall Pkwy
Panama City, FL 32404
Phone (850) 763-0505
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 9759 | FL | |
| Orthopedic Physical Therapist | 2251X0800X | 9759 | FL | Yes |
Addresses
Primary practice location
807 N Tyndall Pkwy
Callaway, FL 32404-9495
Mailing address
120 Queens Cir
Panama City, FL 32405-1910
Phone (850) 747-1198
Other providers in Callaway, FL
- 626 North Tyndall Parkway Operations LLC
- Sylvia Lynn Abercrombie-Broad
- Rebecca Barrett
- Allison Blackstock
- Mary Virginia Blue
- Tammy Carwile Campbell
- Michelle J Cerbantec
- Cathy Cook Christodoulou
- Boyd A Clark
- Compass Physical Therapy
All providers in Callaway, FL · Orthopedic Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.