Kimberly Yvette Campbell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2805 Issued in MD

Practice address

8607 2ND Ave
Suite 506-a
Silver Spring, MD 20910-3355

Phone

(301) 589-5533

Fax

(301) 589-2838

NPI assigned

Nov 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 6, 2019 through May 6, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1245410463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8607 2ND AVE",
            "address_2": "SUITE 506-A",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103355",
            "telephone_number": "301-589-5533",
            "fax_number": "301-589-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8607 2ND AVE",
            "address_2": "SUITE 506-A",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103355",
            "telephone_number": "301-589-5533",
            "fax_number": "301-589-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KIMBERLY",
        "middle_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "1634",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "2805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Lund Camilli, PHARMD
• Cyd Patrice Campbell, MD
• Georgia Gilles Campbell
• Jewel Leoneslie Campbell I
• Jillian Campbell, MS, RN, CPNP-PC
• Elsi Lorena Campos, R.N.
• Robert David Camps, DDS
• Bawi Can
• Veronica L Canada, DPT
• Angela Renae Canady, M.D.

• Clinical Psychologist in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.