Keith Edward Campbell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05191 Issued in TX

Practice address

11521 Ranch Rd 620 N
Austin, TX 78726-1139

Phone

(512) 687-0556

Fax

(512) 687-0560

NPI assigned

Mar 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Specialty Clinic Medical Group PLLCGroup PAC ID 4082017512, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: telemed2u.keithcampbell@160918.advancedmd-direct.com

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.

• Specialty Clinic Medical Group, PLLC

  • Psychiatry Physician
  • Austin, TX
  • NPI 1629409909
  Medicare reassignment Care Compare group
• Austin Kidney Associates PA

  • Nephrology Physician
  • Austin, TX
  • NPI 1154669331
  NPD (past)
• Neha Reshamwala MD PA

  • Allergy & Immunology Physician
  • Austin, TX
  • NPI 1164725214
  NPD (past)
• Rediclinic Austin, LLC

  • Clinic/Center
  • Austin, TX
  • NPI 1558679662
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1598899445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GREENWAY PLZ",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460905",
            "telephone_number": "866-607-7334",
            "fax_number": "713-358-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11521 RANCH RD 620 N",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787261139",
            "telephone_number": "512-687-0556",
            "fax_number": "512-687-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KEITH",
        "middle_name": "EDWARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Renee Campbell
• Jakob Campbell
• Julia Campbell, PHD, AUD
• Kali Campbell
• Keeley Campbell
• Kelly Anne Campbell, MD
• Kendall Campbell, LMFT-ASSOCIATE
• Lexi Rose Campbell
• Linda Campbell, RD
• Lynn Campbell, OTR

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.