Donald A Campbell Jr.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301046758 Issued in MI

Practice address

11270 E 13 Mile Rd
Suite 4
Warren, MI 48093-2599

Phone

(586) 574-0630

Fax

(586) 574-0636

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Henry Ford Health St. John Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment NPD
• Henry Ford Health St. John Hospital

  • Multi-Specialty Clinic/Center
  • Detroit, MI
  • NPI 1457663197

  Family Medicine

  NPD
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1740281997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11270 E 13 MILE RD",
            "address_2": "SUITE 4",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932599",
            "telephone_number": "586-574-0630",
            "fax_number": "586-574-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11270 E 13 MILE RD",
            "address_2": "SUITE 4",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932599",
            "telephone_number": "586-574-0630",
            "fax_number": "586-574-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DONALD",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301046758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP NUMBER",
            "identifier": "700E031610",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "0500014",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha E Caldwell
• Charlotte Jean Caligiuri, D.O.
• Claudine Hocamis Calinawan
• Breanna Selena Calliotte
• Calvin C Brown Jr DDS PLLC
• Robert Allen Canner
• Lakisha Cannon
• Cappri LLC
• Eva A Carababas, PH.D.
• Christina Carbone

• Family Medicine Physician in Warren, MI
• Providers in Warren, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.