Teresa R Campbell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13619 Issued in CA

Practice address

825 Delbon Ave
Turlock, CA 95382-2016

Phone

(209) 664-2790

Fax

(209) 664-2797

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Cep America - California

  • Emergency Medicine Physician
  • Manteca, CA
  • NPI 1316693187
  NPD (past)
• Vepema Medical Group

  • Emergency Medicine Physician
  • Turlock, CA
  • NPI 1356502496
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1164574646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4978",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953524978",
            "telephone_number": "209-575-4575",
            "fax_number": "209-575-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 DELBON AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822016",
            "telephone_number": "209-664-2790",
            "fax_number": "209-664-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "TERESA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13619",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP7094C",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "7094",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA13619",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• California Oncology Medical Group of Turlock, Inc.
• California State University Stanislaus
• California State University, Stanislaus Student Health Center
• Gisela Camarena
• Camille L. Holmes
• Erica Campos, MD
• Jamie Campos
• Juan Carlos Canale, M.D.
• Linette Candelario
• Karina Cantu

• Physician Assistant in Turlock, CA
• Providers in Turlock, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.