Individual provider Active NPI

Jason Travis Campbell, D.C.

  • Chiropractor
  • Greeley, CO
National Provider Identifier
1366577017
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5067 Issued in CO
Practice address
3000 W 10TH St
Greeley, CO 80634-5335
Phone
(970) 346-9031
Fax
(970) 346-9708
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5067 CO Primary

Addresses

Primary practice location

3000 W 10TH St
Greeley, CO 80634-5335

Mailing address

3000 W 10TH St
Greeley, CO 80634-5335
Phone (970) 346-9031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001024 CO Practitioner - Chiropractic 6507779956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Campbell Chiropractic, P.C. 2 clinicians

Practice addresses (Care Compare)

3000 W 10TH St
Greeley, CO 80634-5335
Phone (970) 346-9031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5067COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Health by Design Chiropractic, Inc. CurrentSince Mar 26, 2018 Accepting new patients
Campbell Chiropractic, P.C. Chiropractor CurrentSince Apr 1, 2003 Accepting new patients

Locations

3000 W 10th St
Greeley, CO 80634
Phone (970) 346-9031

Organizations & group practices 2

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366577017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345335",
            "telephone_number": "970-346-9031",
            "fax_number": "970-346-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345335",
            "telephone_number": "970-346-9031",
            "fax_number": "970-346-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JASON",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.