Active NPI
John Robert Campbell, PAC
- Physician Assistant
- Boulder, CO
National Provider Identifier
1669575452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1215
- Practice address
- 2880 Folsom St
Suite 100
Boulder, CO 80304-3739 - Phone
- (303) 327-7047
- Fax
- (303) 443-7168
- NPI assigned
- Sep 6, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1215 | CO | Primary |
Addresses
Primary practice location
2880 Folsom St
Suite 100
Boulder, CO 80304-3739
Mailing address
2880 Folsom St
Suite 100
Boulder, CO 80304-3739
Phone (303) 237-7047
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00377349 | Other | CO | RAILROAD MEDICARE |
| 52004082 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Emory University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2880 Folsom St
Suite 100
Boulder, CO 80304-3739
2880 Folsom St
Suite 100
Boulder, CO 80304-3769
Hospital & facility affiliations
- Trail Winds Hospice
- Boulder Community Health
- Longs Peak Hospital
- Ivinson Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Community Health | Past | Accepting new patients |
Interoperability endpoints
- zcampbell@bch.gwaydirect.com
- john.campbell@bimpc.eclinicaldirectplus.com
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.
-
- Internal Medicine Physician
- Boulder, CO
- NPI 1104911361
-
- Primary Care Clinic/Center
- Boulder, CO
- NPI 1740837137
Hospital & facility affiliations 37
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Boulder, CO
- NPI 1093357907
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1669575452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2880 FOLSOM ST",
"address_2": "SUITE 100",
"city": "BOULDER",
"state": "CO",
"postal_code": "803043739",
"telephone_number": "303-237-7047",
"fax_number": "303-443-7168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2880 FOLSOM ST",
"address_2": "SUITE 100",
"city": "BOULDER",
"state": "CO",
"postal_code": "803043739",
"telephone_number": "303-327-7047",
"fax_number": "303-443-7168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "JOHN",
"middle_name": "ROBERT",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "1215",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00377349",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "52004082",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.