Individual provider Active NPI

Lakesia Shunta' Campbell, IDMT

  • Independent Duty Medical Technicians
  • San Antonio, TX
National Provider Identifier
1255567368
Registry record updated Jun 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty Medical TechniciansTaxonomy code 1710I1003X
Practice address
RR #2 Box 5425
343 TRS/Mas
San Antonio, TX 78257
Phone
(210) 295-8337
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Medical Technicians 1710I1003X Primary

Addresses

Primary practice location

RR #2 Box 5425
343 TRS/Mas
San Antonio, TX 78257

Mailing address

RR 2 Box 5425
343 TRS/ Mas
San Antonio, TX 78257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1255567368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 5425",
            "address_2": "343 TRS/ MAS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR #2 BOX 5425",
            "address_2": "343 TRS/MAS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78257",
            "telephone_number": "210-295-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "LAKESIA",
        "middle_name": "SHUNTA'",
        "name_prefix": "Mrs.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.