Active NPI
Addie Campbell-Mungen
- Contractor
- Baconton, GA
National Provider Identifier
1629926225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- MSW012852
- Practice address
- 9237 US Highway 19
Baconton, GA 31716-7441 - Phone
- (448) 488-6758
- NPI assigned
- Mar 19, 2026
- Last updated
- Mar 19, 2026
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | MSW012852 | GA | Primary |
Addresses
Primary practice location
9237 US Highway 19
Baconton, GA 31716-7441
Mailing address
9237 US Highway 19
Baconton, GA 31716-7441
Phone (448) 488-6758
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 |
|---|---|---|---|
| MSW012852 | GA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773878400000",
"number": "1629926225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9237 US HIGHWAY 19",
"city": "BACONTON",
"state": "GA",
"postal_code": "317167441",
"telephone_number": "448-488-6758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9237 US HIGHWAY 19",
"city": "BACONTON",
"state": "GA",
"postal_code": "317167441",
"telephone_number": "448-488-6758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL-MUNGEN",
"first_name": "ADDIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-19",
"last_updated": "2026-03-19",
"certification_date": "2026-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "GA",
"license": "MSW012852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baconton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.