Active NPI
Holly N Campbell, DPT
- Physical Therapist
- Port Orange, FL
National Provider Identifier
1346590965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305207561
- Practice address
- 5535 S Williamson Blvd
Port Orange, FL 32128-8311 - Phone
- (180) 033-0771
- NPI assigned
- Sep 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305207561 | VA | Primary |
| Physical Therapist | 225100000X | 6047 | KY |
Addresses
Primary practice location
5535 S Williamson Blvd
Port Orange, FL 32128-8311
Mailing address
1986 Old Vincennes Rd
New Albany, IN 47150-5493
Phone (502) 939-0130
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6047 | KY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 2305207561 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347408000000",
"number": "1346590965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1986 OLD VINCENNES RD",
"city": "NEW ALBANY",
"state": "IN",
"postal_code": "471505493",
"telephone_number": "502-939-0130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5535 S WILLIAMSON BLVD",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321288311",
"telephone_number": "180-033-0771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "HOLLY",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-11",
"last_updated": "2012-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305207561",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "6047",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.