Kelly Michelle Campbell, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1168389 Issued in TX

Practice address

1628 19TH St
Lubbock, TX 79401-4895

Phone

(806) 219-0500

Fax

(806) 766-1286

NPI assigned

Feb 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lubbock Independent School District

  • Developmental Disabilities Clinic/Center
  • Lubbock, TX
  • NPI 1669543401
  NPD (past)

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1144785221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794014895",
            "telephone_number": "806-219-0500",
            "fax_number": "806-766-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794014895",
            "telephone_number": "806-219-0500",
            "fax_number": "806-766-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KELLY",
        "middle_name": "MICHELLE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1168389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3946352-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Michelle Camp, MD
• Caroline Sarah Campbell
• Cory Campbell, LPC
• Cullen Lee Campbell, L.S.A.
• Drew McIntire Campbell, MD
• Kenneth Campbell Jr., CSA,SA-C,LSA
• Samuel J. Campbell, M.D.
• Stacy Campbell
• Sydney Campbell
• Melissa A Campos, OTA

• Physical Therapist in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.