Active NPI
Brandon Campbell
- Long-Term Care Clinical Nurse Specialist
- Louisville, KY
National Provider Identifier
1629744677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long-Term Care Clinical Nurse Specialist
- License
- 364SL0600X
- Practice address
- 4120 Wooded Acre LN
Louisville, KY 40245-2938 - Phone
- (502) 243-1643
- NPI assigned
- Aug 19, 2021
- Last updated
- Aug 19, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Long-Term Care Clinical Nurse Specialist | 364SL0600X | 364SL0600X | KY | Primary |
Addresses
Primary practice location
4120 Wooded Acre LN
Louisville, KY 40245-2938
Mailing address
4121 Wooded Acre Lane
Louisville, KY 40245
Phone (502) 243-1643
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 364SL0600X | KY | MD | Rehabilitation Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1629744677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4121 WOODED ACRE LANE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40245",
"telephone_number": "502-243-1643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4120 WOODED ACRE LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402452938",
"telephone_number": "502-243-1643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "BRANDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-19",
"last_updated": "2021-08-19",
"certification_date": "2021-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "364SL0600X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Long-Term Care",
"state": "KY",
"license": "364SL0600X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.