Individual provider Active NPI

James Everett Campbell, DMD

  • General Practice Dentistry
  • Fuquay Varina, NC
National Provider Identifier
1740538487
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10501 Issued in NC
Practice address
1213 N Main St
Fuquay Varina, NC 27526-2616
Phone
(919) 552-9711
NPI assigned
Aug 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10501 NC Primary

Addresses

Primary practice location

1213 N Main St
Fuquay Varina, NC 27526-2616

Mailing address

2809 Croix PL
Raleigh, NC 27614-9155
Phone (919) 539-2259

Other practice location 1

12450 Cleveland Rd Ste 100
Garner, NC 27529-8355
Phone (919) 772-9927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180209000856 NC Order and Referring Only - DentistPractitioner - Dentist 7719247873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10501NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lane and Associates I DDS PA General Practice PastSince Dec 6, 2020 Accepting new patients
Lane & Associates DDS Xvii PA General Practice PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

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": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1740538487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 CROIX PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276149155",
            "telephone_number": "919-539-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262616",
            "telephone_number": "919-552-9711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12450 Cleveland Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Garner",
            "state": "NC",
            "postal_code": "275298355",
            "country_code": "US",
            "telephone_number": "919-772-9927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JAMES",
        "middle_name": "EVERETT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-28",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.