Active NPI
Jerry Neal Campbell Jr., PSY.D.
- Clinical Psychologist
- Murfreesboro, TN
National Provider Identifier
1275680845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2488
- Practice address
- 418 N Maney Ave
Murfreesboro, TN 37130-2921 - Phone
- (615) 896-8080
- Fax
- (615) 895-2049
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2488 | TN | Primary |
Addresses
Primary practice location
418 N Maney Ave
Murfreesboro, TN 37130-2921
Mailing address
418 N Maney Ave
Murfreesboro, TN 37130-2921
Phone (615) 896-8080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040831000136 | TN | Practitioner - Clinical Psychologist | 0345215612 | Practice locations: Murfreesboro, TN |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275680845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "418 N MANEY AVE",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371302921",
"telephone_number": "615-896-8080",
"fax_number": "615-895-2049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "418 N MANEY AVE",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371302921",
"telephone_number": "615-896-8080",
"fax_number": "615-895-2049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "JERRY",
"middle_name": "NEAL",
"name_suffix": "Jr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "2488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murfreesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.