Individual provider Active NPI

Julie Young Campbell, OD

  • Optometrist
  • Panama City, FL
National Provider Identifier
1669510111
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2920 Issued in FL
Practice address
725 N Tyndall Pkwy
Panama City, FL 32404-3219
Phone
(850) 785-3426
Fax
(850) 785-6556
NPI assigned
Feb 4, 2007
Sex
Female
Sole proprietor
No

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
Optometrist 152W00000X OPC2920 FL Primary

Addresses

Primary practice location

725 N Tyndall Pkwy
Panama City, FL 32404-3219

Mailing address

725 N Tyndall Pkwy
Panama City, FL 32404-3219
Phone (850) 785-3426

Other identifiers 1

IdentifierTypeStateIssuer
20661OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329001420 FL Practitioner - Optometry 6103718580 Practice locations: Panama City, FL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

725 N Tyndall Pkwy
Panama City, FL 32404-3219
Phone (850) 785-3426

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC2920FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Center of North Florida, P.a. Optometrist Past Accepting new patients
Eye Center of North Florida, P.a. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669510111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 N TYNDALL PKWY",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324043219",
            "telephone_number": "850-785-3426",
            "fax_number": "850-785-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N TYNDALL PKWY",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324043219",
            "telephone_number": "850-785-3426",
            "fax_number": "850-785-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG CAMPBELL",
        "first_name": "JULIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20661",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.