Everett W. Campbell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

EC066609 Issued in MI

Practice address

7633 E Jefferson Ave
Suite 340
Detroit, MI 48214-3730

Phone

(313) 822-9801

Fax

(313) 822-1030

NPI assigned

Dec 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ecampbel@direct.dmc.org
• Direct secure messaging: ecampbell@hcde.adaptamed.direct-ci.com

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.

• Health Centers Detroit Foundation, Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1518026541
  Medicare reassignment NPD

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1710046792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 REGENTS DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480845421",
            "telephone_number": "248-362-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7633 E JEFFERSON AVE",
            "address_2": "SUITE 340",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143730",
            "telephone_number": "313-822-9801",
            "fax_number": "313-822-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "EVERETT",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "EC066609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4542490",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Yvette Campbell-Perry, RN
• Cari Sue Campbell, NNP
• Chardae Campbell
• Ebony Campbell
• Emily Kristen Campbell, PA-C
• Jaila Campbell
• John Campbell
• Kristen Denise Campbell
• Maia Campbell, BS
• Margaret Lorene Campbell, PHD, RN

• Family Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.