Coty L Campbell, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1694 Issued in SC

Practice address

1600 Lake Murray Blvd
Columbia, SC 29212-8623

Phone

(803) 731-9600

Fax

(803) 731-0297

NPI assigned

Jan 31, 2007

Last updated

Mar 17, 2018By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

University of South Carolina School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia Dermatology LLCGroup PAC ID 5698086460, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

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.

• Columbia Dermatology LLC

  • Dermatology Physician
  • Columbia, SC
  • NPI 1417349747
  Medicare reassignment Care Compare group NPD
• Raymond E. O'Keefe, M.D. PA

  • Dermatology Physician
  • Columbia, SC
  • NPI 1366622565
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1265579106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKE MURRAY BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292128623",
            "telephone_number": "803-731-9600",
            "fax_number": "803-731-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKE MURRAY BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292128623",
            "telephone_number": "803-731-9600",
            "fax_number": "803-731-0297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2241 Bush River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292105626",
            "country_code": "US",
            "telephone_number": "803-731-9600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "COTY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "1694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "P604057400",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Campbell Diaz
• Chana Campbell-Nelson, QBA, LBA
• Berry Allen Campbell, MD
• Cayla Hunter Campbell, MD
• Christopher Mark Campbell
• Emily Young Campbell, MD
• Joseph A Campbell, M.D.
• Justin Campbell, O.D.
• Kendall Nicole Campbell, MD
• Lakeyna Campbell

• Family Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.