Individual provider Active NPI

Kathleen Campos, APRN

  • Family Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1295130466
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61451991 Issued in WA
Practice address
501 SE 172ND Ave Ste 220
Vancouver, WA 98684-9542
Phone
(360) 882-2778
NPI assigned
Oct 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN001797 NV
Family Nurse Practitioner 363LF0000X 201609585NP-PP OR
Family Nurse Practitioner 363LF0000X AP61451991 WA Primary

Addresses

Primary practice location

501 SE 172ND Ave Ste 220
Vancouver, WA 98684-9542

Mailing address

PO Box 4825
Portland, OR 97208-4825
Phone (503) 494-4779

Other practice location 1

3303 SW Bond Ave
Suite 10
Portland, OR 97239-4501
Phone (503) 494-4779

Other names 1

  • Kathleen Mae Ramirez Campos Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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
I20170424001810 OR Practitioner - Nurse Practitioner 6608152848 Reassigns benefits to 1 organization
I20230823002017 WA Practitioner - Nurse Practitioner 6608152848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

501 SE 172ND Ave
Vancouver, WA 98684-9542
Phone (360) 882-2778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN001797NVMDFamily Nurse Practitioner
201609585NP-PPORMDFamily Nurse Practitioner
AP61451991WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Somnique Health PC CurrentSince Oct 21, 2019 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Sep 11, 2023 Accepting new patients
The Vancouver Clinic Inc PS Current Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Sep 11, 2023 Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

9450 SW Barnes Rd
Ste 140
Portland, OR 97225
Phone (503) 688-5536

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

501 SE 172nd Ave
Vancouver, WA 98684

501 SE 172nd Ave
Ste 220
Vancouver, WA 98684
Phone (360) 882-2777

Interoperability endpoints

  • Direct secure messaging: kcampos22417@tvc-direct.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1295130466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "503-494-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE 172ND AVE STE 220",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986849542",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3303 SW Bond Ave",
            "address_2": "Suite 10",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972394501",
            "country_code": "US",
            "telephone_number": "503-494-4779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "KATHLEEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001797",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201609585NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61451991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN MAE",
            "last_name": "CAMPOS",
            "middle_name": "RAMIREZ",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.