Active NPI
Jean Mary Campaiola, M.D.
- Psychiatry Physician
- Ft. Myers, FL
National Provider Identifier
1164516696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME84150
- Practice address
- 939 Pondella Road
Fact Team
Ft. Myers, FL 33903 - Phone
- (239) 656-3461
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME84150 | FL | Primary |
| Psychiatry Physician | 2084P0800X | 96-00474 | NC |
Addresses
Primary practice location
939 Pondella Road
Fact Team
Ft. Myers, FL 33903
Mailing address
14036 Shimmering Lake Court
Ft. Myers, FL 33907
Phone (239) 415-4845
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME84150 | FL | MD | Psychiatry Physician |
| 96-00474 | NC | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164516696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14036 SHIMMERING LAKE COURT",
"city": "FT. MYERS",
"state": "FL",
"postal_code": "33907",
"telephone_number": "239-415-4845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 PONDELLA ROAD",
"address_2": "FACT TEAM",
"city": "FT. MYERS",
"state": "FL",
"postal_code": "33903",
"telephone_number": "239-656-3461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPAIOLA",
"first_name": "JEAN",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME84150",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "96-00474",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft. Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.