Nicole Campbell, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11029998 Issued in FL

Practice address

1481 SW 105TH Ave
Pembroke Pines, FL 33025-4771

Phone

(954) 608-9843

NPI assigned

Dec 8, 2023

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

Medicare fee-for-service enrollment

Enrolled in FL

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.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Luisa Vega DNP LLCGroup PAC ID 3577872605, 83 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Dr Luisa Vega DNP LLC

  • Nurse Practitioner
  • Lake Mary, FL
  • NPI 1497123319

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Senior Living Memory Health, Inc.

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1851847834
  Medicare reassignment

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702771200000",
    "number": "1447027461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 SW 105TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330254771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 SW 105TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330254771",
            "telephone_number": "954-608-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "NICOLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-17",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11029998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Campbell Manor
• Christine Tamara Campbell, LCSW
• Indra Campbell
• Jennifer N Campbell, APRN
• Kimberly Campbell
• Beverly Teresa Campos King, M.D.
• Keiry Candelario
• Tracey Candelora, ARNP
• Joheiri Dariana Canelo Alcantara
• Gayl Canfield, PHD, RDN, LDN

• Psychiatric/Mental Health Nurse Practitioner in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2023; 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.