Individual provider Active NPI

Marcia Raylene Pritchett Campbell, D.C.

  • Chiropractor
  • Dacula, GA
National Provider Identifier
1730369604
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6054 Issued in GA
Practice address
802 Dacula Rd
Suite 202
Dacula, GA 30019-3324
Phone
(770) 827-9695
NPI assigned
Nov 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6054 GA Primary

Addresses

Primary practice location

802 Dacula Rd
Suite 202
Dacula, GA 30019-3324

Mailing address

PO Box 1930
Dacula, GA 30019-0033
Phone (770) 827-9695

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110608000347 GA Practitioner - Chiropractic 2567649163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

802 Dacula Rd
Suite 202
Dacula, GA 30019-3416
Phone (770) 236-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6054GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Chiropractic, Inc. Chiropractor CurrentSince Mar 12, 2011 Accepting new patients

Locations

802 Dacula Rd
Ste 202
Dacula, GA 30019
Phone (770) 236-9355

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1730369604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1930",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300190033",
            "telephone_number": "770-827-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 DACULA RD",
            "address_2": "SUITE 202",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300193324",
            "telephone_number": "770-827-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARCIA",
        "middle_name": "RAYLENE PRITCHETT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "6054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.