Individual provider Active NPI

Nancy L Campbell, M.D.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1558432005
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18089 Issued in MS
Practice address
1200 N State St
Suite 500
Jackson, MS 39202-2000
Phone
(601) 352-2273
Fax
(601) 714-3415
NPI assigned
Nov 13, 2006
Last updated
Mar 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18089 MS Primary

Addresses

Primary practice location

1200 N State St
Suite 500
Jackson, MS 39202-2000

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446
Phone (901) 227-3255

Other identifiers 1

IdentifierTypeStateIssuer
02489072MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20041101000596 MS Practitioner - Internal Medicine 0547222622 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18089MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Baptist Medical Center, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Mississippi Baptist Medical Center, Inc. CurrentSince Sep 1, 2016 Accepting new patients

Locations

1200 N State St
Ste 480
Jackson, MS 39202
Phone (601) 352-2273

1200 N State St
Ste 500
Jackson, MS 39202
Phone (601) 352-2273

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1558432005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "telephone_number": "901-227-3255",
            "fax_number": "901-227-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "SUITE 500",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022000",
            "telephone_number": "601-352-2273",
            "fax_number": "601-714-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "NANCY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "18089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02489072",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.