Individual provider Active NPI

Lauren Suzanne Campbell

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1184002040
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
274576 Issued in MA
Practice address
1340 Boylston St
Boston, MA 02215-4302
Phone
(617) 267-0900
Fax
(617) 247-3912
NPI assigned
May 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 263501 MA
Internal Medicine Physician 207R00000X 274576 MA Primary

Addresses

Primary practice location

1340 Boylston St
Boston, MA 02215-4302

Mailing address

1340 Boylston St
Boston, MA 02215-4302
Phone (617) 267-0900

Other practice location 1

1493 Cambridge St
Cambridge, MA 02139-1047
Phone (617) 591-6300

Other practice location 2

1340 Boylston St
Boston, MA 02215-4302
Phone (617) 267-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240509000375 WA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4880997501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
263501MAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1184002040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154302",
            "telephone_number": "617-267-0900",
            "fax_number": "617-247-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154302",
            "telephone_number": "617-267-0900",
            "fax_number": "617-247-3912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1493 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021391047",
            "country_code": "US",
            "telephone_number": "617-591-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1340 Boylston St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022154302",
            "country_code": "US",
            "telephone_number": "617-267-0900",
            "fax_number": "617-247-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "LAUREN",
        "middle_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "263501",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "274576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.