Individual provider Active NPI

Robert M Campbell, MD

  • Pediatric Cardiology Physician
  • Atlanta, GA
National Provider Identifier
1386694446
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
O30029 Issued in GA
Practice address
5461 Meridian Mark Rd Ste 530
Atlanta, GA 30342-3283
Phone
(404) 256-2593
Fax
(678) 547-1494
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X O30029 GA Primary

Addresses

Primary practice location

5461 Meridian Mark Rd Ste 530
Atlanta, GA 30342-3283

Mailing address

2835 Brandywine Rd
Suite 300
Atlanta, GA 30341-5510
Phone (770) 488-9202

Other identifiers 1

IdentifierTypeStateIssuer
00353405BMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sibley@choa.gadirect.com Health Information Exchange (HIE) Children's Healthcare of Atlanta

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20091007000719 GA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 4587638788

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O30029GAMDPediatric Cardiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1386694446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 BRANDYWINE RD",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415510",
            "telephone_number": "770-488-9202",
            "fax_number": "678-547-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 530",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423283",
            "telephone_number": "404-256-2593",
            "fax_number": "678-547-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "O30029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00353405B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sibley@choa.gadirect.com",
            "affiliation": "Y",
            "endpointDescription": "Sibley",
            "affiliationName": "Children's Healthcare of Atlanta",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PHI",
            "address_1": "5461 Meridian Mark Rd Ste 530",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303423283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.