Individual provider Active NPI

Tyler William Campbell, D.O.

  • Critical Care Medicine (Internal Medicine) Physician
  • Wright Patterson Afb, OH
National Provider Identifier
1477086452
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
34.017240 Issued in OH
Practice address
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Phone
(937) 257-1591
Fax
(937) 656-1128
NPI assigned
Apr 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 34.017240 OH
Internal Medicine Physician 207R00000X DO2022 AL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X DO2022 AL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 34.017240 OH Primary
Pulmonary Disease Physician 207RP1001X DO2022 AL

Addresses

Primary practice location

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529

Mailing address

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Phone (937) 257-1591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20260507000646 OH Practitioner - Critical Care (Intensivists) 2163797259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Alabama College of Osteopathic Medicine, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

120 E Pugh Dr
Springboro, OH 45066-7805

301 Fisher St
RM 1G123
Keesler Afb, MS 39534-2519

33 W Rahn Rd
Dayton, OH 45429-2219

81 MDG
301 Fisher Street Room 1G123
Keesler Afb, MS 39534-2508

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2022ALMDPulmonary Disease Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1477086452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-1591",
            "fax_number": "937-656-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "TYLER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "34.017240",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "DO2022",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AL",
            "license": "DO2022",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "34.017240",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AL",
            "license": "DO2022",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wright Patterson Afb, OH

Sources for this page

Verify at the official NPI Registry.