Jacqueline Campbell, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1138494 Issued in KY

Practice address

1550 Highway 15 S Ste 240
Jackson, KY 41339-0709

Phone

(606) 824-5037

Fax

(606) 824-5042

NPI assigned

Jan 3, 2024

Last updated

Jan 3, 2024By 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

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County Line Primary CareGroup PAC ID 0547691289, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• County Line Primary Care

  dba Jackson Medical Clinic Family Health Care

  • Rural Health Clinic/Center
  • Jackson, KY
  • NPI 1609378132
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1235909946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 HIGHWAY 15 S STE 240",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413390709",
            "telephone_number": "606-824-5037",
            "fax_number": "606-824-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 HIGHWAY 15 S STE 240",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413390709",
            "telephone_number": "606-824-5037",
            "fax_number": "606-824-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JACQUELINE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "1138494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Burge
• George Edward Burnette, MD
• Verna Jean Burnette, PAC
• Candice Lee Campbell, PHARMD RPH
• Dennis B Campbell, M.D.
• Jerri Campbell, NP
• Jerry Lee Campbell Jr., APRN
• Jessica Renee Carlington, LPCA
• Central Kentucky Therapy Services, PLLC
• Darlene Childers

• Nurse Practitioner in Jackson, KY
• Providers in Jackson, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.