Individual provider Active NPI

Pamela A Campbell, MD

  • Child & Adolescent Psychiatry Physician
  • Springfield, IL
National Provider Identifier
1679517288
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
036-121704 Issued in IL
Practice address
319 E Madison St FL 3
Springfield, IL 62701-1035
Phone
(217) 545-8000
Fax
(217) 545-2275
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036121704 IL
Child & Adolescent Psychiatry Physician 2084P0804X 036-121704 IL Primary

Addresses

Primary practice location

319 E Madison St FL 3
Springfield, IL 62701-1035

Mailing address

319 E Madison St
3Rd Floor
Springfield, IL 62701
Phone (217) 545-8000

Other identifiers 1

IdentifierTypeStateIssuer
036121704MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081014000713 IL Practitioner - Psychiatry 7911919287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc Psychiatry CurrentSince Nov 3, 2008 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Nov 3, 2008 Accepting new patients

Locations

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

319 E Madison St
Fl 3
Springfield, IL 62701
Phone (217) 545-7627

Interoperability endpoints

  • Direct secure messaging: pamelacampbell@siusm.allscriptsdirect.net

Organizations & group practices 3

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1679517288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 E MADISON ST",
            "address_2": "3RD FLOOR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62701",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E MADISON ST FL 3",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011035",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036121704",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036-121704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036121704",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.