Individual provider Active NPI

Candace L. Campbell, APRN-CNP

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1275976664
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209701 Issued in OK
Practice address
1923 S Utica Ave FL 4
Tulsa, OK 74104-6520
Phone
(918) 748-7650
Fax
(918) 403-6341
NPI assigned
Apr 16, 2013
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A003840 AR
Family Nurse Practitioner 363LF0000X 209701 OK Primary

Addresses

Primary practice location

1923 S Utica Ave FL 4
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130816000547 AR Practitioner - Nurse Practitioner 9931341153 Reassigns benefits to 3 organizations
I20230321001252 OK Practitioner - Nurse Practitioner 9931341153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A003840ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2013 Accepting new patients
St. John Physicians, Inc CurrentSince Jan 9, 2023 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2013 Accepting new patients
St. John Physicians, Inc. CurrentSince Jan 8, 2023 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Arkansas Children's Hospital CurrentSince Jul 1, 2013 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Feb 1, 2015 Accepting new patients
Arkansas Childrens Hospital CurrentSince Jul 1, 2013 Accepting new patients

Locations

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
#854
Little Rock, AR 72202

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

12455 E 100th St N
Ste 260
Owasso, OK 74055
Phone (918) 274-5560

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1923 S Utica Ave
Fl 4
Tulsa, OK 74104
Phone (918) 748-7650

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1275976664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-744-2630",
            "fax_number": "918-744-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE FL 4",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-748-7650",
            "fax_number": "918-403-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CANDACE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A003840",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "209701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.