Individual provider Active NPI

Davneatra Foster Campbell, MSW, LCSW

  • Clinical Social Worker
  • Rocky Mount, NC
National Provider Identifier
1154707446
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C010690 Issued in NC
Practice address
90 Guardian CT
Rocky Mount, NC 27804-3017
Phone
(252) 212-3350
Fax
(252) 212-0322
NPI assigned
Aug 10, 2015
Last updated
Feb 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C010690 NC Primary

Addresses

Primary practice location

90 Guardian CT
Rocky Mount, NC 27804-3017

Mailing address

PO Box 2723
Rocky Mount, NC 27802-2723
Phone (252) 212-3486

Other identifiers 1

IdentifierTypeStateIssuer
C010690OtherNCLCSW LICENSE/CERTIFICATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171207002170 NC Practitioner - Clinical Social Worker 9931466448 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Opportunities Industrialization Center, Inc. CurrentSince Oct 8, 2017 Accepting new patients
Opportunities Industrialization Center, Inc CurrentSince Oct 8, 2017 Accepting new patients
Opportunities Industrialization Center, Inc CurrentSince Feb 19, 2019 Accepting new patients
Opportunities Industrialization Center, Inc. CurrentSince Oct 8, 2017 Accepting new patients
Opportunities Industrialization Center, Inc CurrentSince Oct 8, 2017 Accepting new patients

Locations

1041 Noell Ln
#B
Rocky Mount, NC 27804
Phone (252) 962-3450

111 S Fairview Rd
Rocky Mount, NC 27801
Phone (252) 212-3486

300 N Grace St
Rocky Mount, NC 27804
Phone (252) 210-9856

801 Williford St
Rocky Mount, NC 27803
Phone (252) 210-9856

90 Guardian Ct
Rocky Mount, NC 27804
Phone (252) 212-3350

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1154707446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2723",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278022723",
            "telephone_number": "252-212-3486",
            "fax_number": "252-212-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 GUARDIAN CT",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043017",
            "telephone_number": "252-212-3350",
            "fax_number": "252-212-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DAVNEATRA",
        "middle_name": "FOSTER",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE/CERTIFICATION NUMBER",
            "identifier": "C010690",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.