Active NPI
Victoria Lynn Campbell, RDN
- Registered Dietitian
- Canton, MS
National Provider Identifier
1699036178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D1688
- Practice address
- 117 Coventry LN
Canton, MS 39046-6610 - Phone
- (662) 212-2219
- NPI assigned
- May 31, 2012
- 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 |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | DT82188 | TX | |
| Registered Dietitian | 133V00000X | D1688 | MS | Primary |
Addresses
Primary practice location
117 Coventry LN
Canton, MS 39046-6610
Mailing address
117 Coventry LN
Canton, MS 39046-6610
Phone (662) 212-2219
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149984001 | Medicaid | TX | |
| 207164901 | Medicaid | TX |
Other names 1
- Victoria Templeton
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 |
|---|---|---|---|
| DT82188 | TX | MD | Pediatric Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1338422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628121600000",
"number": "1699036178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 COVENTRY LN",
"city": "CANTON",
"state": "MS",
"postal_code": "390466610",
"telephone_number": "662-212-2219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 COVENTRY LN",
"city": "CANTON",
"state": "MS",
"postal_code": "390466610",
"telephone_number": "662-212-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "VICTORIA",
"middle_name": "LYNN",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-31",
"last_updated": "2021-08-05",
"certification_date": "2021-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "TX",
"license": "DT82188",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MS",
"license": "D1688",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149984001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207164901",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "VICTORIA",
"last_name": "TEMPLETON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Canton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.