Active NPI
Dennis Ray Campbell, M.S.
- Psychologist
- Mexico, MO
National Provider Identifier
1336314582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 01380
- Practice address
- 321 West Promenade
Mexico, MO 65251-1753 - Phone
- (573) 582-1234
- Fax
- (573) 582-1212
- NPI assigned
- Apr 29, 2008
- Last updated
- Jan 31, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 01380 | MO | Primary |
Addresses
Primary practice location
321 West Promenade
Mexico, MO 65251-1753
Mailing address
340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01380 | MO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517356800000",
"number": "1336314582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 KELLEY PKWY",
"city": "MEXICO",
"state": "MO",
"postal_code": "652653811",
"telephone_number": "573-582-1234",
"fax_number": "573-582-1212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 WEST PROMENADE",
"city": "MEXICO",
"state": "MO",
"postal_code": "652511753",
"telephone_number": "573-582-1234",
"fax_number": "573-582-1212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "DENNIS",
"middle_name": "RAY",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-29",
"last_updated": "2018-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "01380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mexico, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.