Sharly Campbell, BS HIV PROVIDER

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

715 Freedom Plains Rd
Poughkeepsie, NY 12603-2688

Phone

(877) 541-8075

NPI assigned

Nov 18, 2019

Last updated

Apr 14, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prevention Healthcare Services Inc

  • Clinical Medical Laboratory
  • Poughkeepsie, NY
  • NPI 1790304285
  NPD Authorized official

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1710523428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SOMMERSET DR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 FREEDOM PLAINS RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032688",
            "telephone_number": "877-541-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SHARLY",
        "credential": "BS HIV PROVIDER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Tekakwitha Campana
• Chantice Campbell
• Dennis Campbell, LPN
• Jana Campbell, LPN
• Melody D Campbell, RN
• Aarti Campo, M.D.
• Jeniffer Mary Campo, MD
• Stephanie Canales
• Cancer Care of Poughkeepsie, LLP
• Kara Ann Cannelli

• Community Health Worker in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Community Health Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.