Individual provider Active NPI

Jeffrey Alan Campbell, M.D.

  • Family Medicine Physician
  • Jeffersonville, IN
National Provider Identifier
1518063585
Registry record updated Mar 4, 2016
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jul 18, 2024.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01036153 Issued in IN
Practice address
1804 E 10TH St
Jeffersonville, IN 47130-6016
Phone
(812) 288-2488
Fax
(812) 288-6603
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01036153 IN Primary
Family Medicine Physician 207Q00000X 23424 KY
Addiction Medicine (Family Medicine) Physician 207QA0401X 23424 KY
Addiction Medicine (Anesthesiology) Physician 207LA0401X 23424 KY
Addiction Medicine (Anesthesiology) Physician 207LA0401X 01036153A IN

Addresses

Primary practice location

1804 E 10TH St
Jeffersonville, IN 47130-6016

Mailing address

1804 E 10TH St
Jeffersonville, IN 47130-6016
Phone (812) 288-2488

Other identifiers 6

IdentifierTypeStateIssuer
080067815OtherINPALMETTO
100464320MedicaidIN
1195507OtherINCHA HEALTH
000000050807OtherINANTHEM
004272OtherINSIHO
1018897OtherINCHAMPUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23424KYMDAddiction Medicine (Anesthesiology) Physician
01036153INMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1518063585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 E 10TH ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471306016",
            "telephone_number": "812-288-2488",
            "fax_number": "812-288-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 E 10TH ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471306016",
            "telephone_number": "812-288-2488",
            "fax_number": "812-288-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01036153",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "23424",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "KY",
            "license": "23424",
            "primary": false
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "KY",
            "license": "23424",
            "primary": false
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "IN",
            "license": "01036153A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "080067815",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100464320",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA HEALTH",
            "identifier": "1195507",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000050807",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "004272",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "1018897",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.