Michael Andrew Wade Campbell

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

404144 Issued in GA

Practice address

4550 Amysaye Walk NW
Acworth, GA 30101-8342

Phone

(404) 917-7992

NPI assigned

Nov 26, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1154891877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 AMYSAYE WALK NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018342",
            "telephone_number": "404-917-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 AMYSAYE WALK NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018342",
            "telephone_number": "404-917-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW WADE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "GA",
            "license": "404144",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": "404144",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "GA",
            "license": "404144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ISSUE NUMBER",
            "identifier": "404144",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon Scott Byrd, DC
• Sherie Nicole Byrd, M.D.
• C & S Health and Rehabilitative Service, LLC
• Brian Callahan, D.C.
• Ashley Nicole Campbell, FNP
• Carissa Eve Campos, D.D.S.
• Candid Hearts Healthcare Services LLC
• John Michael Caraway, DPT
• Care Assurance LLC
• Care Intl LLC

• Personal Care Attendant in Acworth, GA
• Providers in Acworth, GA by specialty
• Personal Care Attendant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.