Active NPI
Robert M Campbell, MD
- Pediatric Cardiology Physician
- Atlanta, GA
National Provider Identifier
1386694446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- O30029
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00353405B | Medicaid | GA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091007000719 | GA | Practitioner - Cardiovascular Disease (Cardiology) | 4587638788 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O30029 | GA | MD | Pediatric 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.