Patrick Campbell

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

86528 Issued in GA

Practice address

7229 Nightstalker Way
Fort Campbell, KY 42223

Phone

(270) 798-2056

NPI assigned

Jun 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1559952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1285293795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7229 NIGHTSTALKER WAY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7229 NIGHTSTALKER WAY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-08",
        "last_updated": "2023-04-12",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "86528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tonia.m.wilson2.civ@mail.mil",
            "affiliation": "N",
            "address_1": "6600 Van Aalst Blvd Bldg 9250",
            "city": "Fort Benning",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319052102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zachery Call, DPT
• Joshua Dale Calloway, FNP
• Heidi Cameron, L.AC
• Brian Patrick Campbell, MS, LAT, ATC
• Keith Campbell, PA-C
• Dessie Daleen Campeau, RN,MSN,CMCN
• Matthew Campise, PA-C
• Phillip Randal Cannon Jr., DPT
• Sandra Kay Cannon, LPC
• Lyle Wayne Carlson, PHD

• Family Medicine Physician in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.

Verify at the official NPI Registry.