Emily O. Campbell, MD
Individual provider Active NPI Family Medicine Physician · Bristol, TN
NPI 1508091034 · NPPES record last updated Jan 8, 2019
Key facts
- NPI
- 1508091034
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 48036 (TN)
- Practice address
- 240 Medical Park Blvd
Ste 3600
Bristol, TN 37620-7346 - Phone
- (423) 990-2414
- Fax
- (423) 990-2417
- NPI assigned
- May 28, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- East Tennessee State University Quillen College of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Holston Medical Group PC
Practice addresses (Care Compare)
240 Medical Park Blvd
Bristol, TN 37620-7352
240 Medical Park Blvd
Suite 1500
Bristol, TN 37620-7353
Phone (423) 990-2460
322 Steeles Rd
Bristol, TN 37620-9532
Phone (423) 217-1360
350 Steeles Rd
Unit 1
Bristol, TN 37620-9532
Phone (423) 844-4925
Hospital & facility affiliations
- Wellmont Bristol Regional Medical Center
- Johnson City Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120206000114 | TN | Practitioner - Emergency Medicine |
4486811304 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD48036 | TN | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holston Medical Group PC | Family Medicine | Current |
Accepting new patients |
| Page Memorial Hospital Inc. | Past | Accepting new patients |
Locations
350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
2204 Pavilion Dr
Ste 200
Kingsport, TN 37660
Phone (423) 224-3900
Interoperability endpoints
- emilycampbell@hmgpath.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | MD48036 | TN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 48036 | TN | Yes |
Addresses
Primary practice location
240 Medical Park Blvd
Ste 3600
Bristol, TN 37620-7346
Mailing address
PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2066
Other providers in Bristol, TN
- Camb Op LLC
- Cambridge Care Center LLC
- Michael C Cameron
- Campbell Clinic PC
- Campbell Clinic PC
- Thomas Aaron Campbell
- Alan G Carnell
- Carol a Dewey
- Henry Austin Carr
- Jennifer Nicole Carter
All providers in Bristol, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.