Autumn Campbell, PA-C – Physician Assistant

Key facts

NPI: 1396110656
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: 004534 (OH)
Practice address: 4634 Hills and Dales Rd NW
Canton, OH 44708-1510
Phone: (330) 477-0255
Fax: (330) 479-0392
NPI assigned: Dec 11, 2015
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Ohio Physician Professional Corporation Hospitalist Physician · Canton, OH · NPI 1417016973

Medicare reassignment Care Compare group OH

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Alliance Community Hospital General Acute Care Hospital · Alliance, OH · NPI 1942385794

Care Compare affiliation Hospital
Aultman Hospital General Acute Care Hospital · Canton, OH · NPI 1356366991

Care Compare affiliation Hospital
City of Wooster General Acute Care Hospital · Wooster, OH · NPI 1437156247

Care Compare affiliation Hospital
Orrville Hospital Foundation Critical Access Hospital · Orrville, OH · NPI 1891718375

Care Compare affiliation Hospital
Trinity Hospital Twin City Critical Access Hospital · Dennison, OH · NPI 1992096192

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Physician Assistant
Education: Other, 2015
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: Ohio Physician Professional Corporation (143 clinicians)

Practice addresses (Care Compare)

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 454-8076

2600 6TH SWST
Canton, OH 44710-1702
Phone (330) 363-1342

2600 W 6TH St
Canton, OH 44710-1702

4634 Hills and Dales Rd NW
Canton, OH 44708-1510
Phone (330) 477-0255

Hospital & facility affiliations

Aultman Hospital Hospital · Canton, OH · CCN 360084
Aultman Orrville Hospital Hospital · Orrville, OH · CCN 361323
Alliance Community Hospital Hospital · Alliance, OH · CCN 360131
Twin City Medical Center Hospital · Dennison, OH · CCN 361302
Wooster Community Hospital Hospital · Wooster, OH · CCN 360036

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OH
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20160310001271	OH	Practitioner - Physician Assistant	8729384193	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
004534	OH	MD	Physician Assistant

Interoperability endpoints

Direct secure messaging: autumnc@neoe.medentdirect.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X	004534	OH	Yes

Addresses

Primary practice location

4634 Hills and Dales Rd NW
Canton, OH 44708-1510

Mailing address

4634 Hills and Dales Rd NW
Canton, OH 44708-1510
Phone (330) 477-0255

Other providers in Canton, OH

All providers in Canton, OH · Physician Assistant in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.