Individual provider Active NPI

Wendy Maxine Harrison-Campbell, FNP

  • Family Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1568027886
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11001689 Issued in FL
Practice address
931 Village Blvd Ste 904
West Palm Beach, FL 33409-1939
Phone
(561) 683-0302
NPI assigned
May 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95030869 CA
Family Nurse Practitioner 363LF0000X 11001689 FL Primary

Addresses

Primary practice location

931 Village Blvd Ste 904
West Palm Beach, FL 33409-1939

Mailing address

2300 N Florida Mango Rd
West Palm Beach, FL 33409-6416
Phone (561) 683-0302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240604002954 CA Practitioner - Nurse Practitioner 5496297574 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11001689FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Consolidated Tribal Health Project, Inc. CurrentSince Apr 7, 2024 Accepting new patients

Locations

6991 N State St
Redwood Vly, CA 95470
Phone (707) 467-5620

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15156/brand/1/csg/1/fhir/r4
  • Direct secure messaging: wendy.clarke.1@15156.direct.athenahealth.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1568027886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N FLORIDA MANGO RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096416",
            "telephone_number": "561-683-0302",
            "fax_number": "561-683-9823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 VILLAGE BLVD STE 904",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334091939",
            "telephone_number": "561-683-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON-CAMPBELL",
        "first_name": "WENDY",
        "middle_name": "MAXINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030869",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.