Individual provider Active NPI

Debra E Campbell, MSN, CNM

  • Advanced Practice Midwife
  • Decatur, IL
National Provider Identifier
1558690115
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209007790 Issued in IL
Practice address
544 W Pershing Rd
Decatur, IL 62526-3226
Phone
(217) 872-2400
Fax
(217) 875-4680
NPI assigned
Dec 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209007790 IL Primary

Addresses

Primary practice location

544 W Pershing Rd
Decatur, IL 62526-3226

Mailing address

544 W Pershing Rd
Decatur, IL 62526-3226
Phone (217) 872-2400

Other practice location 1

1750 E Lake Shore Dr Ste 200
Decatur, IL 62521-3806
Phone (217) 422-2500

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)
Enrolled
Credentials
Certified Nurse Midwife, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
209007790ILMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1558690115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 W PERSHING RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263226",
            "telephone_number": "217-872-2400",
            "fax_number": "217-875-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 W PERSHING RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263226",
            "telephone_number": "217-872-2400",
            "fax_number": "217-875-4680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 E Lake Shore Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625213806",
            "country_code": "US",
            "telephone_number": "217-422-2500",
            "fax_number": "217-875-4680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DEBRA",
        "middle_name": "E",
        "credential": "MSN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-10",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209007790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.