Individual provider Active NPI

Henry Grady Campbell Jr, R.N. C.

  • Addiction (Substance Use Disorder) Registered Nurse
  • Albuquerque, NM
National Provider Identifier
1396855409
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
12898 Issued in AK
Practice address
1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Phone
(800) 465-8262
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X R 0024189 OK
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 12898 AK Primary

Addresses

Primary practice location

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153

Mailing address

864 Rimrock Dr
Gallup, NM 87301-7347
Phone (505) 863-5071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
12898AKMDAddiction (Substance Use Disorder) Registered Nurse
R 0024189OKMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1396855409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 RIMROCK DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873017347",
            "telephone_number": "505-863-5071",
            "fax_number": "505-722-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "800-465-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL JR",
        "first_name": "HENRY",
        "middle_name": "GRADY",
        "name_prefix": "Mr.",
        "credential": "R.N. C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "R 0024189",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "12898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.