NPIMap

Individual provider Active NPI

Constance Blair Campbell, MD

  • Family Medicine Physician
  • Lakewood, WA
National Provider Identifier
1124355144
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60463468 Issued in WA
Practice address
10510 Gravelly Lake Dr SW
Lakewood, WA 98499-5036
Phone
(253) 589-7030
Fax
(253) 589-7033
NPI assigned
Nov 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60463468 WA Primary

Addresses

Primary practice location

10510 Gravelly Lake Dr SW
Lakewood, WA 98499-5036

Mailing address

1019 Pacific Ave
Ste. 300
Tacoma, WA 98402-4443
Phone (253) 722-1540

Other identifiers 1

IdentifierTypeStateIssuer
MD9572MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151118002586 WA Practitioner - Family Practice 0042463804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care CurrentSince Oct 4, 2015 Accepting new patients
Community Health Care CurrentSince Oct 4, 2015 Accepting new patients
Franciscan Health System Past Accepting new patients

Locations

134 188th St S
Spanaway, WA 98387
Phone (253) 847-2304

1708 E 44th St
Tacoma, WA 98404
Phone (253) 471-4553

1148 Broadway
Ste 100
Tacoma, WA 98402
Phone (253) 441-4742

1202 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 441-4742

11225 Pacific Ave S
Tacoma, WA 98444
Phone (253) 536-2020

10510 Gravelly Lake Dr SW
Tacoma, WA 98499
Phone (253) 589-7030

Interoperability endpoints

  • Direct secure messaging: constance.campbellmd.p1@direct.chc-tacoma.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HEDCAA
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Care 72 clinicians

Practice addresses (Care Compare)

10510 Gravelly Lake Dr SW
Lake Wood Clinic
Lakewood, WA 98499-5036
Phone (253) 589-7030

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

NPI Registry JSON

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1124355144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 PACIFIC AVE",
            "address_2": "STE. 300",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024443",
            "telephone_number": "253-722-1540",
            "fax_number": "253-597-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984995036",
            "telephone_number": "253-589-7030",
            "fax_number": "253-589-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CONSTANCE",
        "middle_name": "BLAIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-11",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60463468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD9572",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.