Organization Active NPI

Lawrence D. Campbell, M.D. PC

  • Internal Medicine Physician
  • Bay Shore, NY
National Provider Identifier
1740510031
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
166249-1 Issued in NY
Legal business name
LAWRENCE D. CAMPBELL, M.D. PC
Practice address
32 E Main St
Bay Shore, NY 11706-8301
Phone
(631) 969-9600
Fax
(631) 968-7624
NPI assigned
Jan 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Authorized official

Name
Lawrence D Campbell, M.D.
Title
President
Phone
(631) 969-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 166249-1 NY Primary

Addresses

Primary practice location

32 E Main St
Bay Shore, NY 11706-8301

Mailing address

32 E Main St
Bay Shore, NY 11706-8301
Phone (631) 969-9600

Other identifiers 2

IdentifierTypeStateIssuer
000AN2OtherNYEMPIRE BCBS
00977793MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270080000000",
    "number": "1740510031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068301",
            "telephone_number": "631-969-9600",
            "fax_number": "631-968-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068301",
            "telephone_number": "631-969-9600",
            "fax_number": "631-968-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE D. CAMPBELL, M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-08",
        "last_updated": "2010-04-01",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-969-9600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "166249-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "000AN2",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00977793",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.