Kelley Renee Campbell, RN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209009568 Issued in IL

Practice address

1 Memorial Dr
Alton, IL 62002-6722

Phone

(618) 463-7474

Fax

(618) 463-7543

NPI assigned

May 27, 2012

Last updated

Feb 20, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Southern Illinois University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Emergency Good Samaritan, IncGroup PAC ID 1658529342, 28 clinicians

Midwest Medical and Occupational Services SCGroup PAC ID 3476794496, 4 clinicians

Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Meds Inpatient Services Associates, IncGroup PAC ID 1557865250, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Clay County Hospital Hospital, Flora, IL, CCN 141351
• SSM Health St Mary's Hospital -Centralia Hospital, Centralia, IL, CCN 140034

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• Direct secure messaging: kcampb56@yourcarecommunity.org
• Direct secure messaging: kcampbell220545@direct-ehr-ssmhc.com

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.

• Anderson Medical Group, LLC

  • General Practice Physician
  • Maryville, IL
  • NPI 1700807716
  Medicare reassignment Care Compare group NPD
• Meds Inpatient Services Associates, Inc

  • Hospitalist Physician
  • Centralia, IL
  • NPI 1154215895
  Medicare reassignment Care Compare group NPD
• Midwest Emergency Good Samaritan, Inc

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1629367578
  Medicare reassignment Care Compare group NPD
• Midwest Medical and Occupational Services SC

  dba Express Care of Mt Vernon

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1679814305
  Medicare reassignment Care Compare group NPD
• Alton-Griffin Emergency Group PC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1891104824

  Nurse Practitioner

  Medicare reassignment NPD
• Midwest Emergency Anderson Health, Inc

  • Emergency Medicine Physician
  • Staunton, IL
  • NPI 1710647615
  Medicare reassignment NPD
• Midwest Emergency Centralia Campus Associates, Inc

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1396034245
  Medicare reassignment NPD
• Midwest Inpatient Anderson Health, Inc

  • Emergency Medicine Physician
  • Maryville, IL
  • NPI 1821758608
  Medicare reassignment NPD
• Southeastern Emergency Services of Memphis, P.C.

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1164454450

  IL, Nurse Practitioner

  Medicare reassignment NPD
• BC Illinois Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1215952163

  Nurse Practitioner

  NPD (past)
• Central Illinois Radiological Associates, LTD.

  dba Central Illinois Radiological Associates

  • Diagnostic Radiology Physician
  • Peoria, IL
  • NPI 1538192828
  NPD (past)
• Christian Hospital Physician Billing Services LLC

  • Cardiovascular Disease Physician
  • Saint Louis, MO
  • NPI 1689828501
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of Clay

  dba Clay County Hospital

  • Critical Access Hospital
  • Flora, IL
  • NPI 1184655136
  Care Compare affiliation
• St Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation

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

{
    "created_epoch": "1338076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1245590074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "618-463-7474",
            "fax_number": "618-463-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "618-463-7474",
            "fax_number": "618-463-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KELLEY",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-27",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009568",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa A Cagle, D.M.D.
• James Joseph Cahill, DMD
• Ashley Lynn Cain
• Ronald Calaway-Habeck, DMD
• Calmwaters Counseling & Resource Center Inc
• Susan Campbell, MA
• Zoe Campbell
• Nathan Campo
• Abigail Maxine Caperton, FNP
• Connie Lynn Carpenter-Farley, D.C.

• Family Nurse Practitioner in Alton, IL
• Providers in Alton, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.