Organization Active NPI

Edward B Kampsen MD PA

  • Otolaryngology Physician
  • Tampa, FL
National Provider Identifier
1699971804
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EDWARD B KAMPSEN MD PA
Practice address
2835 W de Leon St
#202
Tampa, FL 33609-4130
Phone
(813) 877-2685
Fax
(813) 876-5872
NPI assigned
Jun 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Christina Ruble
Title
Office Admin
Phone
(813) 877-2685

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

2835 W de Leon St
#202
Tampa, FL 33609-4130

Mailing address

2835 W. de Leon St.
#202
Tampa, FL 33609
Phone (813) 877-2685

Other identifiers 1

IdentifierTypeStateIssuer
30250OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100330000947 FL Part B Supplier - Clinic/Group Practice 4385770262 Receives reassigned benefits from 2 practitioners
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

2835 W De Leon St
Ste 202
Tampa, FL 33609
Phone (813) 877-2685

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1699971804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 W. DE LEON ST.",
            "address_2": "#202",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33609",
            "telephone_number": "813-877-2685",
            "fax_number": "813-876-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 W DE LEON ST",
            "address_2": "#202",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094130",
            "telephone_number": "813-877-2685",
            "fax_number": "813-876-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD B KAMPSEN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "RUBLE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "813-877-2685"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "30250",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.