Individual provider Active NPI

Jonathan M Campbell, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1356576144
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1170 Issued in ME
Practice address
1650 Greenfield St
Wilmington, NC 28401-6456
Phone
(910) 798-3500
Fax
(910) 798-7834
NPI assigned
May 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1170 ME Primary

Addresses

Primary practice location

1650 Greenfield St
Wilmington, NC 28401-6456

Mailing address

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-2774

Other practice location 1

401 N Main Street
Vidant Duplin Hospital Emergency Dept
Kenansville, NC 28349
Phone (910) 296-2774

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcampbell78644@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150317001305 NC Practitioner - Physician Assistant 0648317826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3791MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Mar 9, 2015 Accepting new patients
New Hanover County CurrentSince Aug 23, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Mar 9, 2015 Accepting new patients
Norumbega Medical Specialists, LTD Past Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1650 Greenfield St
Wilmington, NC 28401
Phone (910) 798-3500

Organizations & group practices 4

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": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1356576144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283498801",
            "telephone_number": "910-296-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GREENFIELD ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016456",
            "telephone_number": "910-798-3500",
            "fax_number": "910-798-7834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 N Main Street",
            "address_2": "Vidant Duplin Hospital Emergency Dept",
            "address_purpose": "LOCATION",
            "city": "Kenansville",
            "state": "NC",
            "postal_code": "28349",
            "country_code": "US",
            "telephone_number": "910-296-2774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-21",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcampbell78644@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.