NPIMap

Individual provider Active NPI

Wayne E. Campbell, M.D.

  • Internal Medicine Physician
  • Crestview, FL
National Provider Identifier
1417926577
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME30203 Issued in FL
Practice address
550 Redstone Ave W
Suite 200
Crestview, FL 32536-6430
Phone
(850) 682-6122
Fax
(850) 682-5917
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME30203 FL Primary

Addresses

Primary practice location

550 Redstone Ave W
Suite 200
Crestview, FL 32536-6430

Mailing address

PO Box 2699
Pensacola, FL 32513-2699

Other identifiers 1

IdentifierTypeStateIssuer
058717600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070207000324 FL Practitioner - Internal Medicine 6103828975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Florida College of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

550 W Redstone Ave
Suite 200
Crestview, FL 32536-6429
Phone (850) 682-6122

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Shalimar, FL, CCN 107240
  • Stat Home Health Florida Panhandle LLC Home health agency, Pensacola, FL, CCN 103138
  • Peoples Home Health LLC Home health agency, Pensacola, FL, CCN 109664
  • Amedisys Home Health Home health agency, Pensacola, FL, CCN 108309
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122
  • Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292
  • HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME30203FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Internal Medicine CurrentSince Oct 1, 2012 Accepting new patients
Sacred Heart Health System Inc CurrentSince Oct 1, 2012 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

550 Redstone Ave W
Ste 200
Crestview, FL 32536
Phone (850) 682-6122

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

4586 E Highway 20
Ste B
Niceville, FL 32578
Phone (850) 897-3200

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

Interoperability endpoints

  • Direct secure messaging: wayne.campbell.1@9582.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1417926577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W",
            "address_2": "SUITE 200",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366430",
            "telephone_number": "850-682-6122",
            "fax_number": "850-682-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "WAYNE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME30203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058717600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.