Active NPI
Holly Sue Campbell, COTA
- Contractor
- Abilene, TX
National Provider Identifier
1720367774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 210429
- Practice address
- 317 Saxon St
Abilene, TX 79605-1625 - Phone
- (260) 760-6411
- NPI assigned
- Aug 9, 2011
- Last updated
- Aug 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 210429 | TX | Primary |
Addresses
Primary practice location
317 Saxon St
Abilene, TX 79605-1625
Mailing address
317 Saxon St
Abilene, TX 79605-1625
Phone (260) 760-6411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 210429 | Other | TX | TEXAS STATE LICENSE FOR OCCUPATIONAL THERAPY ASSISTANT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 210429 | TX | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312848000000",
"number": "1720367774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 SAXON ST",
"city": "ABILENE",
"state": "TX",
"postal_code": "796051625",
"telephone_number": "260-760-6411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 SAXON ST",
"city": "ABILENE",
"state": "TX",
"postal_code": "796051625",
"telephone_number": "260-760-6411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "HOLLY",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-09",
"last_updated": "2011-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TX",
"license": "210429",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE LICENSE FOR OCCUPATIONAL THERAPY ASSISTANT",
"identifier": "210429",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Abilene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.