Individual provider Active NPI

Derrick Barrington Campbell, LPN

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1518335215
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
290411-1 Issued in NY
Practice address
830 E 220TH St
Bronx, NY 10467-5312
Phone
(347) 822-8151
NPI assigned
Sep 11, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 290411-1 NY Primary

Addresses

Primary practice location

830 E 220TH St
Bronx, NY 10467-5312

Mailing address

830 E 220TH St
Bronx, NY 10467-5312
Phone (347) 822-8151

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

State licenses

LicenseStateTypeSpecialty
290411-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1518335215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 E 220TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104675312",
            "telephone_number": "347-822-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 E 220TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104675312",
            "telephone_number": "347-822-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DERRICK",
        "middle_name": "BARRINGTON",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "290411-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.