Jeanette Ellen Campbell, P.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

380261 Issued in NY

Practice address

3560 N Buffalo St
Orchard Park, NY 14127-1934

Phone

(716) 662-8510

Fax

(716) 662-8574

NPI assigned

Apr 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 17, 2016 through May 17, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1396700126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271934",
            "telephone_number": "716-662-8510",
            "fax_number": "716-662-8574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271934",
            "telephone_number": "716-662-8510",
            "fax_number": "716-662-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JEANETTE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "380261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01026324",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Calabrese
• Paul G. Calabrese, DDSMS
• Chrissy Calixte
• Brooke Campbell
• Carol M Campbell, SLP
• Michael Campbell, MD
• Peggy Suzanne Canfield, OT
• Mary Patricia Canna, PA
• Kari Patricia Cannata, OSC
• Darren M Caparaso, MD

• Pediatric Nurse Practitioner in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.