Richard Campbell, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00046323 Issued in WA

Practice address

12040 NE 128TH St
Kirkland, WA 98034-3013

Phone

(425) 899-1000

NPI assigned

Jun 27, 2006

Sex

Male

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 5

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evergreen Emergency Services PSGroup PAC ID 4981694155, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Evergreen Emergency Services, PS

  • Emergency Medicine Physician
  • Kirkland, WA
  • NPI 1619912524
  Medicare reassignment Care Compare group
• Ballard Emergency Physicians, P.S.

  • Emergency Medicine Physician
  • Seattle, WA
  • NPI 1619909256
  NPD (past)
• Cep America LLC

  • Emergency Medicine Physician
  • Edmonds, WA
  • NPI 1447484274
  NPD (past)
• Edmonds Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Edmonds, WA
  • NPI 1336181676
  NPD (past)

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

• King County Public Hospital District No. 2

  • General Acute Care Hospital
  • Kirkland, WA
  • NPI 1033174933
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1417984089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 50421",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740421",
            "telephone_number": "800-793-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-899-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00046323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "910861251",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8458614",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON CRIME VICTIMS",
            "identifier": "8942675",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "212018",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BS",
            "identifier": "2162CA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Cameron
• Cynthia Tina Campbell, L.AC.
• Jayna Campbell, COTA
• Kyra Campbell
• Norma Jean Campbell, M.ED.
• Suzanne Marie Campiche, MSW
• Laura Camunez
• Janet Rose Canniff, LMHC
• Charles Cannon, ED.S, NCSP, LMHCA
• Daisha Renee Cannon, LMHCA

• Emergency Medicine Physician in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.