Individual provider Active NPI

Molly Kate Campbell

  • Physician Assistant
  • Cookeville, TN
National Provider Identifier
1164056495
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
406 N Whitney Ave Ste 5
Cookeville, TN 38501-4243
Phone
(931) 783-4269
NPI assigned
Feb 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

406 N Whitney Ave Ste 5
Cookeville, TN 38501-4243

Mailing address

127 N Oak Ave Ste D
Cookeville, TN 38501-2435
Phone (931) 783-5582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200917002016 TN Practitioner - Physician Assistant 3779901004 Reassigns benefits to 1 organization
I20221214000195 MD Practitioner - Physician Assistant 3779901004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, Inc 373 clinicians

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216

2435 W Belvedere Ave
Baltimore, MD 21215-5224

Hospital & facility affiliations

  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4216TNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc. CurrentSince Dec 12, 2022 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Dec 12, 2022 Accepting new patients
University Health System Inc CurrentSince Jun 1, 2021 Accepting new patients
University Health System, Inc CurrentSince Jun 1, 2021 Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2435 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-0900

1940 Alcoa Hwy
Ste E260
Knoxville, TN 37920
Phone (865) 305-6955

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

Organizations & group practices 15

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.

View all 15

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": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1164056495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N OAK AVE STE D",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012435",
            "telephone_number": "931-783-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N WHITNEY AVE STE 5",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014243",
            "telephone_number": "931-783-4269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MOLLY",
        "middle_name": "KATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.