Gospha Gordon Campbell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

102029 Issued in CA

Practice address

1850 S Waterman Ave, # F
San Bernardino, CA 92408

Phone

(909) 890-9393

Fax

(909) 890-9394

NPI assigned

May 4, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FCCECD/Endpoint/FCCECD

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.

• Gospha G, Campbell MD Inc

  • Adult Medicine Physician
  • San Bernardino, CA
  • NPI 1215182803
  Medicare reassignment Authorized official
• Urgent Family Care Inc

  • Urgent Care Clinic/Center
  • San Bernardino, CA
  • NPI 1972861011
  NPD Authorized official
• Wilson Izquierdo MD, Inc

  • Urgent Care Clinic/Center
  • San Bernardino, CA
  • NPI 1306106000
  NPD (past)

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

{
    "created_epoch": "1209859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1306012935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 S WATERMAN AVE # F",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082877",
            "telephone_number": "909-890-9393",
            "fax_number": "909-890-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 S WATERMAN AVE, # F",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "909-890-9393",
            "fax_number": "909-890-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "GOSPHA",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-04",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "102029",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "16775",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Elisa Cameli
• Senica Marie E Camello
• Wendi Lynn Cameron
• Nellie Elizabeth Campa Perez, RD, CDE
• Emalynn Campbell
• Henroy Campbell
• Norine Campbell, PSYD
• Spencer James Campbell III
• Ana Estela Campos
• Catherine Campos, PMHNP

• Family Medicine Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.