Individual provider Active NPI

Cynthia Lynn Campbell, FNP

  • Family Nurse Practitioner
  • Heber City, UT
National Provider Identifier
1134112998
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
852049924405 Issued in UT
Practice address
728 W 100 S Ste 1
Heber City, UT 84032-3764
Phone
(435) 654-4067
Fax
(435) 654-4192
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 852049924405 UT Primary

Addresses

Primary practice location

728 W 100 S Ste 1
Heber City, UT 84032-3764

Mailing address

292 E 300 N
Midway, UT 84049-6917
Phone (435) 654-2285

Other identifiers 1

IdentifierTypeStateIssuer
852049924405OtherUTUTAH STATE LICENSE NUMBER

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

State licenses

LicenseStateTypeSpecialty
852049924405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
C L Cambell LLC Family PastSince Jan 1, 2011 Accepting new patients

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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1134112998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 E 300 N",
            "city": "MIDWAY",
            "state": "UT",
            "postal_code": "840496917",
            "telephone_number": "435-654-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 W 100 S STE 1",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323764",
            "telephone_number": "435-654-4067",
            "fax_number": "435-654-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CYNTHIA",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "852049924405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH STATE LICENSE NUMBER",
            "identifier": "852049924405",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Heber City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.