Active NPI
Nicole M Campbell, CRNA
- Certified Registered Nurse Anesthetist
- The Dalles, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 201500184CRNA
- Practice address
- 1700 E 19TH St
The Dalles, OR 97058 - Phone
- (541) 296-7760
- NPI assigned
- Dec 30, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 201500184CRNA | OR | Primary |
Addresses
Primary practice location
1700 E 19TH St
The Dalles, OR 97058
Mailing address
PO Box 69355
Baltimore, MD 21264-9355
Other practice location 1
400 9th St
Florence, OR 97439-7398
Phone (541) 997-8412
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NR14585000 | Other | NJ | STATE LICENSE |
| 201500184CRNA | Other | OR | STATE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150630003128 | WA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2860535523 | Reassigns benefits to 9 organizations |
| I20170516000584 | OR | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2860535523 | Reassigns benefits to 6 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bay Area Hospital DistrictPublic Hospital District No. 2, Klickitat County, WashingtonLewis County Hospital District No 1Providence Health and Services Oregon
Practice addresses (Care Compare)
1775 Thompson Rd
Coos Bay, OR 97420-2125
Phone (541) 269-8280
211 NE Skyline Dr
White Salmon, WA 98672-1948
Phone (509) 493-1101
521 Adams Ave
Suite B
Morton, WA 98356-9323
Phone (360) 496-5145
810 12TH St
Hood River, OR 97031-1587
Phone (541) 387-6445
Hospital & facility affiliations
- Bay Area Hospital
- Arbor Health Morton Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201500184CRNA | OR | MD | Certified Registered Nurse Anesthetist |
Practice roles
Locations
400 10th St E
Waconia, MN 55387
940 E 5th St
Coquille, OR 97423
Phone (541) 396-3101
810 12th St
Hood River, OR 97031
Phone (541) 386-3911
1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251
317 Sanders Way
Goldendale, WA 98620
Phone (509) 773-4017
310 S Roosevelt St
Goldendale, WA 98620
Phone (509) 486-2151
901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611
901 Mountain View Dr
Bldg 1
Shelton, WA 98584
Phone (360) 426-1611
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/5c5c3b5c-6128-40bc-b71b-102ccb82d7e7/
Organizations & group practices 29
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.
-
- Critical Access Hospital
- White Salmon, WA
- NPI 1760455687
WA
-
- Critical Access Hospital
- White Salmon, WA
- NPI 1952483653
WA
-
- Critical Access Hospital
- Goldendale, WA
- NPI 1386689487
WA
-
- Medicare Defined Swing Bed Hospital Unit
- Goldendale, WA
- NPI 1093879975
WA
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1154651925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 69355",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212649355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E 19TH ST",
"city": "THE DALLES",
"state": "OR",
"postal_code": "97058",
"telephone_number": "541-296-7760"
}
],
"practiceLocations": [
{
"address_1": "400 9th St",
"address_purpose": "LOCATION",
"city": "Florence",
"state": "OR",
"postal_code": "974397398",
"country_code": "US",
"telephone_number": "541-997-8412",
"fax_number": "541-997-1463",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAMPBELL",
"first_name": "NICOLE",
"middle_name": "M",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-30",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OR",
"license": "201500184CRNA",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "NR14585000",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE",
"identifier": "201500184CRNA",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in The Dalles, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.