NPIMap

Individual provider Active NPI

Jordan Elizabeth Campbell, PA-C

  • Surgical Physician Assistant
  • Grand Junction, CO
National Provider Identifier
1609410307
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0006305 Issued in CO
Practice address
2440 N 11TH St
Grand Junction, CO 81501-8102
Phone
(970) 243-0900
Fax
(970) 245-4235
NPI assigned
Nov 5, 2019
Last updated
Dec 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA.0006305 CO Primary

Addresses

Primary practice location

2440 N 11TH St
Grand Junction, CO 81501-8102

Mailing address

888 St Peppin Dr
Fruita, CO 81521-7410
Phone (307) 349-9577

Other practice location 1

888 St Peppin Dr
Fruita, CO 81521-7410
Phone (307) 349-9577

Other names 1

  • Jordan Hitshew Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200709003267 CO Practitioner - Physician Assistant 3577986405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

627 25
Grand Junction, CO 81505-6401
Phone (970) 242-3535

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Oct 4, 2021 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Oct 4, 2021 Accepting new patients
St Mary's Hospital and Medical Center, Inc Single Specialty Past Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2440 N 11th St
Grand Junction, CO 81501
Phone (970) 243-0900

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1609410307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 ST PEPPIN DR",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815217410",
            "telephone_number": "307-349-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 N 11TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018102",
            "telephone_number": "970-243-0900",
            "fax_number": "970-245-4235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "888 St Peppin Dr",
            "address_purpose": "LOCATION",
            "city": "Fruita",
            "state": "CO",
            "postal_code": "815217410",
            "country_code": "US",
            "telephone_number": "307-349-9577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JORDAN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0006305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "HITSHEW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.