Individual provider Active NPI

Kelsey Campana, FNP-C

  • Family Nurse Practitioner
  • College Station, TX
National Provider Identifier
1396516407
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1142766 Issued in TX
Practice address
4421 State Highway 6 S Ste 100
College Station, TX 77845-6176
Phone
(979) 690-4828
Fax
(979) 690-4829
NPI assigned
Jan 9, 2024
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1142766 TX Primary
Registered Nurse 163W00000X 944771 TX

Addresses

Primary practice location

4421 State Highway 6 S Ste 100
College Station, TX 77845-6176

Mailing address

4421 State Highway 6 S Ste 100
College Station, TX 77845-6176
Phone (979) 690-4828

Other practice location 1

3201 University Dr E Ste 205
Bryan, TX 77802-3482
Phone (512) 579-8797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240514003165 TX Practitioner - Nurse Practitioner 6507207123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

4421 State Hwy 6 S
Suite 100
College Station, TX 77845-6176
Phone (979) 690-4460

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
944771TXMDRegistered Nurse
1142766TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center Family CurrentSince Jul 1, 2024 Accepting new patients
St Joseph Regional Health Center CurrentSince Jul 1, 2024 Accepting new patients
College Station Hospital LP Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

4421 State Highway 6 S
Ste 100
College Station, TX 77845
Phone (979) 731-5200

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1396516407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 STATE HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-690-4828",
            "fax_number": "979-690-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 STATE HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-690-4828",
            "fax_number": "979-690-4829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 University Dr E Ste 205",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "778023482",
            "country_code": "US",
            "telephone_number": "512-579-8797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPANA",
        "first_name": "KELSEY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1142766",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "944771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.