Active NPI
Deanna Campbell, RD
- Registered Dietitian
- West Lafayette, IN
National Provider Identifier
1588276513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 800007
- Practice address
- 6102 Gallegos Dr
West Lafayette, IN 47906-5793 - Phone
- (765) 543-4732
- NPI assigned
- Aug 20, 2020
- Last updated
- Aug 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 800007 | IN | Primary |
Addresses
Primary practice location
6102 Gallegos Dr
West Lafayette, IN 47906-5793
Mailing address
6102 Gallegos Dr
West Lafayette, IN 47906-5793
Phone (765) 543-4732
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221107001157 | IN | Practitioner - Registered Dietitian Or Nutrition Professional | 4082081989 | Practice locations: Lafayette, IN |
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Lafayette, IN 47901
Phone (765) 543-4732
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 800007 | IN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597881600000",
"number": "1588276513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6102 GALLEGOS DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479065793",
"telephone_number": "765-543-4732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6102 GALLEGOS DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479065793",
"telephone_number": "765-543-4732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "DEANNA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-20",
"last_updated": "2020-08-20",
"certification_date": "2020-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "800007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.