Active NPI
Derrick Campbell
- Physical Therapist
- Austin, TX
National Provider Identifier
1417149923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 4700 Seton Center Pkwy
Ste 200
Austin, TX 78759-5295 - Phone
- (512) 439-1000
- NPI assigned
- Aug 17, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
4700 Seton Center Pkwy
Ste 200
Austin, TX 78759-5295
Mailing address
4700 Seton Center Pkwy
Ste 200
Austin, TX 78759-5295
Phone (512) 439-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1169401 | Other | TX | LICENSE# |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ortholonestar, PLLC | Past | Accepting new patients | |
| Ortholonestar, PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Tomball, TX
- NPI 1073475679
-
- Orthopaedic Surgery Physician
- Houston, TX
- NPI 1942860176
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274745600000",
"number": "1417149923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 SETON CENTER PKWY",
"address_2": "STE 200",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787595295",
"telephone_number": "512-439-1000",
"fax_number": "512-439-1081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 SETON CENTER PKWY",
"address_2": "STE 200",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787595295",
"telephone_number": "512-439-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "DERRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-17",
"last_updated": "2010-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE#",
"identifier": "1169401",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.