Active NPI
Lowell Mason Campbell III, PSYD, LP
- Psychologist
- Shakopee, MN
National Provider Identifier
1659393684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP2631
- Practice address
- 287 Marschall Rd Ste 203
Shakopee, MN 55379-1678 - Phone
- (952) 445-1397
- Fax
- (952) 445-1398
- NPI assigned
- Jul 25, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP2631 | MN | Primary |
Addresses
Primary practice location
287 Marschall Rd Ste 203
Shakopee, MN 55379-1678
Mailing address
287 Marschall Rd Ste 203
PO Box 336
Shakopee, MN 55379-1678
Phone (952) 445-1397
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01010981 | Other | MN | PREFERRED ONE |
| 61-20043 | Other | MN | MEDICA ID |
| 1346259041 | Other | MN | IND NPI# |
| 51217CA | Other | MN | BCBS GROUP ID |
| 51053CA | Other | MN | BCBS ID |
| HP19455 | Other | MN | HEALTHPARTNERS |
Other names 1
- Dr. Lowell Mason Campbell III
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP2631 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1659393684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "287 MARSCHALL RD STE 203",
"address_2": "PO BOX 336",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553791678",
"telephone_number": "952-445-1397",
"fax_number": "952-445-1398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "287 MARSCHALL RD STE 203",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553791678",
"telephone_number": "952-445-1397",
"fax_number": "952-445-1398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "LOWELL",
"middle_name": "MASON",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PSYD, LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP2631",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "01010981",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA ID",
"identifier": "61-20043",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IND NPI#",
"identifier": "1346259041",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP ID",
"identifier": "51217CA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ID",
"identifier": "51053CA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP19455",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LOWELL",
"last_name": "CAMPBELL",
"middle_name": "MASON",
"prefix": "DR.",
"suffix": "III",
"credential": "PSYD LP",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Shakopee, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.