Individual provider Active NPI

Lorraine Dome Campbell, PAC

  • Medical Physician Assistant
  • Bakersfield, CA
National Provider Identifier
1194747808
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14728 Issued in CA
Practice address
3838 San Dimas St
Suite A200
Bakersfield, CA 93301-2284
Phone
(661) 654-0200
Fax
(661) 664-2855
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14728 CA Primary

Addresses

Primary practice location

3838 San Dimas St
Suite A200
Bakersfield, CA 93301-2284

Mailing address

3400 Data Dr
Physician Support Services - 2ND FL
Rancho Cordova, CA 95670-7956

Other identifiers 1

IdentifierTypeStateIssuer
G476810OtherCAMEDICAL/BKFD INT MED/DOUG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050119000865 CA Practitioner - Physician Assistant 1254380975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

3838 San Dimas St
Suite B201
Bakersfield, CA 93301-1496
Phone (661) 321-3161

9500 Stockdale Hwy
Bakersfield, CA 93311-3621

Hospital & facility affiliations

  • Around the Clock Home Care Home health agency, Bakersfield, CA, CCN 557765
  • Adventist Health Bakersfield Hospital, Bakersfield, CA, CCN 050455

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA14728CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Aug 1, 2014 Accepting new patients
Polyclinic Medical Center, Inc. Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

3838 San Dimas St
Ste B201
Bakersfield, CA 93301
Phone (661) 321-3161

3838 San Dimas St
Ste A200
Bakersfield, CA 93301
Phone (661) 654-0200

9500 Stockdale Hwy
Ste 201
Bakersfield, CA 93311
Phone (661) 327-1431

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIAIBD

Organizations & group practices 5

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.

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1194747808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "PHYSICIAN SUPPORT SERVICES - 2ND FL",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 SAN DIMAS ST",
            "address_2": "SUITE A200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012284",
            "telephone_number": "661-654-0200",
            "fax_number": "661-664-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "LORRAINE",
        "middle_name": "DOME",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL/BKFD INT MED/DOUG",
            "identifier": "G476810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.