Individual provider Active NPI

Valerie Ann Campbell, NP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1386094241
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2016020415 Issued in MO
Practice address
4400 Clayton Ave
Saint Louis, MO 63110-1624
Phone
(314) 432-3600
NPI assigned
Jun 21, 2016
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2016020415 MO Primary

Addresses

Primary practice location

4400 Clayton Ave
Saint Louis, MO 63110-1624

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other names 1

  • Valerie Ann Vaughn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160805001560 MO Practitioner - Nurse Practitioner 6103110697 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2016020415MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Family Practice, PC Current Accepting new patients
Riverside Family Medicine PC CurrentSince Jun 16, 2016 Accepting new patients
Shriners Hospitals for Children Nurse Practitioner Current Accepting new patients
Sikeston Emergency Group LLC Nurse Practitioner CurrentSince Oct 1, 2017 Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 23, 2023 Accepting new patients
Cep America, LLC Current Accepting new patients
Cep America LLC CurrentSince Mar 1, 2020 Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 23, 2023 Accepting new patients
Cep America LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

200 Corporate Blvd
Lafayette, LA 70508

3129 Blattner Dr
Cpe Girardeau, MO 63703
Phone (573) 335-0166

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

4400 Clayton Ave
Saint Louis, MO 63110
Phone (314) 432-3600

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1386094241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 CLAYTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101624",
            "telephone_number": "314-432-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "VALERIE",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2016020415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "VAUGHN",
            "middle_name": "ANN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.