Individual provider Active NPI

Monte Todd Campbell, DC

  • Chiropractor
  • Stillwater, OK
National Provider Identifier
1619083821
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3262 Issued in OK
Practice address
206 S Main
Ste B
Stillwater, OK 74074
Phone
(405) 743-4340
Fax
(405) 372-7000
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3262 OK Primary

Addresses

Primary practice location

206 S Main
Ste B
Stillwater, OK 74074

Mailing address

206 S Main
Ste B
Stillwater, OK 74074
Phone (405) 743-4340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100630000129 OK Practitioner - Chiropractic 9537227608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3262OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bair Chiropractic, PLLC Chiropractor CurrentSince Jul 1, 2014 Accepting new patients
Advanced Chiropractic & Wellness, PLLC Chiropractor CurrentSince Jul 1, 2014 Accepting new patients

Locations

1405 W 12th Ave
Stillwater, OK 74074
Phone (405) 533-1511

Organizations & group practices 2

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1619083821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S MAIN",
            "address_2": "STE B",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "74074",
            "telephone_number": "405-743-4340",
            "fax_number": "405-372-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S MAIN",
            "address_2": "STE B",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "74074",
            "telephone_number": "405-743-4340",
            "fax_number": "405-372-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MONTE",
        "middle_name": "TODD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.