Active NPI
Vivian Denise Campbell, M.D.
- Psychiatry Physician
- Charlotte, NC
National Provider Identifier
1629177472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 9700209
- Practice address
- 501 Billingsley Rd
Charlotte, NC 28211-1009 - Phone
- (704) 358-2700
- Fax
- (704) 358-2716
- NPI assigned
- Sep 21, 2006
- Last updated
- Jul 9, 2013
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 9700209 | NC | Primary |
Addresses
Primary practice location
501 Billingsley Rd
Charlotte, NC 28211-1009
Mailing address
PO Box 601372
Charlotte, NC 28260-1372
Phone (704) 358-2700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N0020G | Medicaid | NC | |
| 5909693 | Medicaid | NC | |
| 11104 | Other | NC | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9700209 | NC | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Psychiatric Associates P.a. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Charlotte, NC
- NPI 1992756845
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373328000000",
"number": "1629177472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601372",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601372",
"telephone_number": "704-358-2700",
"fax_number": "704-358-2716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 BILLINGSLEY RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111009",
"telephone_number": "704-358-2700",
"fax_number": "704-358-2716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "VIVIAN",
"middle_name": "DENISE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2013-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "9700209",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N0020G",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5909693",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "11104",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.