Individual provider Active NPI

James R Campbell, D.O.

  • Family Medicine Physician
  • Broken Arrow, OK
National Provider Identifier
1720091077
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1880 Issued in OK
Practice address
510 N Elm PL
Broken Arrow, OK 74012-2539
Phone
(918) 251-1391
Fax
(918) 251-3008
NPI assigned
Aug 15, 2006
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1880 OK Primary

Addresses

Primary practice location

510 N Elm PL
Broken Arrow, OK 74012-2539

Mailing address

510 N Elm PL
Broken Arrow, OK 74012-2539
Phone (918) 251-1391

Other identifiers 2

IdentifierTypeStateIssuer
731328479OtherOKTAX IDENTIFICATION NUMBER
1880OtherOKSTATE LICENSE NUMBER

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080506000155 OK Practitioner - Family PracticePractitioner - General Practice 6507945318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

510 N Elm PL
Broken Arrow, OK 74012-2539
Phone (918) 251-1391

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
10.63 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
35.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1880OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
James R. Campbell, D.O., Inc. CurrentSince Apr 11, 2007 Accepting new patients

Locations

500 S Elm Pl
Broken Arrow, OK 74012
Phone (918) 251-1391

510 N Elm Pl
Broken Arrow, OK 74012
Phone (918) 251-1391

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1720091077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122539",
            "telephone_number": "918-251-1391",
            "fax_number": "918-251-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122539",
            "telephone_number": "918-251-1391",
            "fax_number": "918-251-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JAMES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "1880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "731328479",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "1880",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.