Susan Keller Campbell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101050838 Issued in VA

Practice address

8650 Sudley Rd
Suite 306
Manassas, VA 20110-4419

Phone

(703) 393-9494

Fax

(703) 393-8591

NPI assigned

Dec 18, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

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 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pine Grove Pediatrics

  • Pediatrics Physician
  • Manassas, VA
  • NPI 1346303062
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760545479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 SUDLEY RD",
            "address_2": "SUITE 306",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104419",
            "telephone_number": "703-393-9494",
            "fax_number": "703-393-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 SUDLEY RD",
            "address_2": "SUITE 306",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104419",
            "telephone_number": "703-393-9494",
            "fax_number": "703-393-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SUSAN",
        "middle_name": "KELLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101050838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "50320001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "804791",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005635675",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE MAMSI",
            "identifier": "259951",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HEALTHKEEPERS PLUS",
            "identifier": "334844",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE MAMSI",
            "identifier": "2154106",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE MAMSI",
            "identifier": "8154106",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Olivia Campa, LPC
• Campbell Eye PLLC (Piedmont Vision Care)
• Clare Campbell, MSW
• Constance B Campbell, OD
• Susan Brien Campbell, ANP
• Can,Inc (Eye Pro Express)
• Desiree Canizalez
• Katie Cannon
• Carol M Cantello, OTR/L SR FELLOW BC/A
• Hannah Cantrell

• Family Medicine Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.