NPIMap

Organization Active NPI

Bruce D Campbell MD, LLC

  • Family Medicine Physician
  • Free Union, VA
National Provider Identifier
1144362146
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101035228 Issued in VA
Legal business name
BRUCE D CAMPBELL MD, LLC
Practice address
4303 Free Union Road
Free Union, VA 22940
Phone
(434) 978-1691
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Dr. Bruce Donald Campbell Jr., MDNPI 1700922457
Title
Owner/Physician
Phone
(434) 978-1691

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0101035228 VA Primary

Addresses

Primary practice location

4303 Free Union Road
Free Union, VA 22940

Mailing address

PO Box 220
Free Union, VA 22940-0220
Phone (434) 978-1691

Other identifiers 1

IdentifierTypeStateIssuer
005624738MedicaidVA

Other names 1

  • Bruce D Campbell MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040803001709 VA Part B Supplier - Clinic/Group Practice 9032180054 Receives reassigned benefits from 21 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlottesville, VA; Orange, VA; Free Union, VA
O20230803004336 VA Part B Supplier - Clinic/Group Practice 3072974260 Receives reassigned benefits from 2 practitioners
Practice locations: Free Union, VA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0949541Bruce D Campbell MD4303 Free Union Road, Free Union, VA 22940Certificate of waiverAug 4, 2026

National Provider Directory

National Provider Directory

Locations

4303 Free Union Rd
#220
Free Union, VA 22940

4303 Free Union Rd
#200
Free Union, VA 22940

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1144362146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "FREE UNION",
            "state": "VA",
            "postal_code": "229400220",
            "telephone_number": "434-978-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 FREE UNION ROAD",
            "city": "FREE UNION",
            "state": "VA",
            "postal_code": "22940",
            "telephone_number": "434-978-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE D CAMPBELL MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "434-978-1691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101035228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005624738",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bruce D Campbell MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Free Union, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.