Individual provider Active NPI

Courtney Jayne Campana, PA-C

  • Surgical Physician Assistant
  • Columbus, OH
National Provider Identifier
1710210570
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.002960 Issued in OH
Practice address
111 S Grant Ave Ste 350
Columbus, OH 43215-4701
Phone
(614) 566-9160
NPI assigned
Sep 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.002960 OH
Surgical Physician Assistant 363AS0400X 50.002960 OH Primary

Addresses

Primary practice location

111 S Grant Ave Ste 350
Columbus, OH 43215-4701

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other practice location 1

111 S Grant Ave Ste 350
Columbus, OH 43215-4701
Phone (614) 566-9160

Other identifiers 1

IdentifierTypeStateIssuer
9747601OtherOHAETNA PIN

Other names 1

  • Courtney Jayne Roland Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccampana224190@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090928000483 OH Practitioner - Physician Assistant 4789730094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbus Radiology CorpGroup PAC ID 6507754983, 290 clinicians

Practice addresses (Care Compare)

111 S Grant Ave
Ohiohealth Grant Medical Center
Columbus, OH 43215-4701
Phone (614) 228-7231

401 N Ewing St
Fairfield Medical Center
Lancaster, OH 43130-3372
Phone (614) 228-7231

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.002960OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Sep 1, 2017 Accepting new patients
Columbus Radiology Corp CurrentSince Feb 8, 2022 Accepting new patients

Locations

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

111 S Grant Ave
Ste 350
Columbus, OH 43215
Phone (614) 566-9160

393 E Town St
Ste 109
Columbus, OH 43215
Phone (614) 228-1090

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

Interoperability endpoints

  • Direct secure messaging: courtney.campana.1@16701.direct.athenahealth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1710210570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE STE 350",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154701",
            "telephone_number": "614-566-9160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S Grant Ave Ste 350",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154701",
            "country_code": "US",
            "telephone_number": "614-566-9160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPANA",
        "first_name": "COURTNEY",
        "middle_name": "JAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2022-01-25",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002960",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.002960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "9747601",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccampana224190@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "393 E Town St",
            "address_2": "Ste 109",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432154741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "ROLAND",
            "middle_name": "JAYNE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.