Alyssa Berry Campbell, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4697 Issued in TN

Practice address

1975 W Elk Ave Ste 1
Elizabethton, TN 37643-3787

Phone

(423) 722-2062

Fax

(423) 722-2063

NPI assigned

Jan 29, 2013

Last updated

Jan 30, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physical Therapy Services, P.a.

  • Clinic/Center
  • Elizabethton, TN
  • NPI 1831109867
  NPD (past)

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1184962946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E MAIN ST STE 4",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014891",
            "telephone_number": "423-722-2062",
            "fax_number": "423-722-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 W ELK AVE STE 1",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376433787",
            "telephone_number": "423-722-2062",
            "fax_number": "423-722-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ALYSSA",
        "middle_name": "BERRY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "4697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Burgie Drug Store LLC (Burgie Drug Store)
• Donna Lisa Burleson, RN
• C & SQ Transport (Calvin B. Quesenberry)
• Campbell Clinic PC
• Campbell Clinic, PC
• Charity Faith Campbell, PTA
• Eric Shannon Campbell, P.T.
• Ronda Lynn Carpenter, PHARMD
• Carrefour Counseling & Play Therapy LLC
• Shelley Carroll, MS CCC-SLP

• Occupational Therapist in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.