Individual provider Active NPI

Richard Douglas Campa, PH.D.

  • Clinical Psychologist
  • Austin, TX
National Provider Identifier
1649305566
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24748 Issued in TX
Practice address
5806 Mesa Dr Ste 345
Austin, TX 78731-3770
Phone
(512) 419-0001
Fax
(512) 419-0008
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 24748 TX Primary

Addresses

Primary practice location

5806 Mesa Dr Ste 345
Austin, TX 78731-3770

Mailing address

5806 Mesa Dr Ste 345
Austin, TX 78731-3770
Phone (512) 419-0001

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
24748TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649305566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5806 MESA DR STE 345",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313770",
            "telephone_number": "512-419-0001",
            "fax_number": "512-419-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5806 MESA DR STE 345",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313770",
            "telephone_number": "512-419-0001",
            "fax_number": "512-419-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPA",
        "first_name": "RICHARD",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "24748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.