Active NPI
Christine R Campbell, MA, CCC-SLP
- Speech-Language Pathologist
- Fayettville, NC
National Provider Identifier
1659518173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 11697
- Practice address
- 2401 Roberson Street
Fayettville, NC 28305 - Phone
- (910) 483-8331
- Fax
- (910) 483-8335
- NPI assigned
- Jan 21, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA9752 | FL | |
| Speech-Language Pathologist | 235Z00000X | 11697 | NC | Primary |
Addresses
Primary practice location
2401 Roberson Street
Fayettville, NC 28305
Mailing address
1024 Florida Ave S
Suite a
Rockledge, FL 32955-2152
Phone (321) 634-3688
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA9752 | FL | MD | Speech-Language Pathologist |
| 11697 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448409600000",
"number": "1659518173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1024 FLORIDA AVE S",
"address_2": "SUITE A",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329552152",
"telephone_number": "321-634-3688",
"fax_number": "321-504-0955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 ROBERSON STREET",
"city": "FAYETTVILLE",
"state": "NC",
"postal_code": "28305",
"telephone_number": "910-483-8331",
"fax_number": "910-483-8335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "CHRISTINE",
"middle_name": "R",
"credential": "MA, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-21",
"last_updated": "2015-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA9752",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "11697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.