Jermaine Campbell DO, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JERMAINE CAMPBELL DO, LLC

Practice address

2701 N Course Dr Apt 125
Pompano Beach, FL 33069-3030

Phone

(754) 264-6061

NPI assigned

Oct 16, 2020

Last updated

Nov 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jermaine Campbell, DONPI 1407017387

Title

Ceo

Phone

(754) 264-6061

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jermaine Campbell, D.O.

  • Internal Medicine Physician
  • Pompano Beach, FL
  • NPI 1407017387
  Authorized official Same address or phone

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1467051896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12491 BAYWIND CT",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N COURSE DR APT 125",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330693030",
            "telephone_number": "754-264-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERMAINE CAMPBELL DO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-16",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-16",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JERMAINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "754-264-6061",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ccmshealth.com",
            "affiliation": "Y",
            "affiliationName": "Customized Care Management services, LLC",
            "address_1": "4121 Parker Ave",
            "city": "West Palm Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334052507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Internal Medicine Physician in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.