NPIMap

Organization Active NPI

Ear, Nose and Throat of Michiana P.C.

Doing business as Campbell Ear, Nose and Throat

  • Specialist
  • Granger, IN
National Provider Identifier
1295726198
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01035158A Issued in IN
Legal business name
EAR, NOSE AND THROAT OF MICHIANA P.C.
Doing business as
Campbell Ear, Nose and Throat
Practice address
209 Florence Avenue
Granger, IN 46530-8048
Phone
(574) 246-1000
Fax
(574) 246-4000
NPI assigned
Oct 31, 2005
Last updated
Mar 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Dr. David A Campbell, MDNPI 1750456026
Title
President
Phone
(574) 246-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 01035158A IN Primary

Addresses

Primary practice location

209 Florence Avenue
Granger, IN 46530-8048

Mailing address

209 Florence Avenue
Granger, IN 46530-8048
Phone (574) 246-1000

Other identifiers 2

IdentifierTypeStateIssuer
200485700AMedicaidIN
200717560AOtherINFIRST STEPS-IN

Other names 1

  • Campbell Ear, Nose and Throat Doing business as

National Provider Directory

National Provider Directory

Locations

100 Navarre Pl
Ste 4430
South Bend, IN 46601
Phone (574) 246-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3596/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1295726198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 FLORENCE AVENUE",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308048",
            "telephone_number": "574-246-1000",
            "fax_number": "574-246-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 FLORENCE AVENUE",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308048",
            "telephone_number": "574-246-1000",
            "fax_number": "574-246-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE AND THROAT OF MICHIANA P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-246-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01035158A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200485700A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST STEPS-IN",
            "identifier": "200717560A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campbell Ear, Nose and Throat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granger, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.