Individual provider Active NPI

Christopher L Campbell, D.O.

  • Family Medicine Physician
  • Roseville, CA
National Provider Identifier
1376647560
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7052 Issued in CA
Practice address
10004 Blue Oaks Blvd
Roseville, CA 95747-5146
Phone
(916) 435-2700
Fax
(916) 435-2701
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7052 CA Primary

Addresses

Primary practice location

10004 Blue Oaks Blvd
Roseville, CA 95747-5146

Mailing address

2241 Sunset Blvd Ste C
Rocklin, CA 95765-4295
Phone (916) 435-2700

Other practice location 1

275 Grass Valley Hwy
Auburn, CA 95603-4533
Phone (530) 885-0344

Other identifiers 1

IdentifierTypeStateIssuer
00AX70520MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170727003979 CA Order and Referring Only - Family PracticePractitioner - Family Practice 3577457233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1376647560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 SUNSET BLVD STE C",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957654295",
            "telephone_number": "916-435-2700",
            "fax_number": "916-435-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 BLUE OAKS BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957475146",
            "telephone_number": "916-435-2700",
            "fax_number": "916-435-2701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 GRASS VALLEY HWY",
            "address_purpose": "LOCATION",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956034533",
            "country_code": "US",
            "telephone_number": "530-885-0344",
            "fax_number": "530-885-8967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX70520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.