Jasper Ahmad Campbell

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

AR5510 Issued in AR

Practice address

31 E Center St Ste 200J
Fayetteville, AR 72701-5348

Phone

(479) 301-8427

NPI assigned

Jan 5, 2018

Sex

Male

Sole proprietor

Yes

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.

• Momentum Health Industries Inc

  • In Home Supportive Care Agency
  • Rogers, AR
  • NPI 1083580856

  In Home Supportive Care

  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 8, 2019.

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1770090243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CARLTON ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727625103",
            "telephone_number": "479-231-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 E CENTER ST STE 200J",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015348",
            "telephone_number": "479-301-8427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Carlton St",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727625103",
            "country_code": "US",
            "telephone_number": "479-361-3073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JASPER",
        "middle_name": "AHMAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-05",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "AR",
            "license": "AR5510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Campbell
• Bradley G Campbell, M.D.
• Caitlin Marie Campbell, DO
• Cathy Campbell, LPC
• Cynthia K Campbell, MSW, LCSW
• John Christy Campbell, M.A.
• Kadie Campbell
• Lucas Kyle Campbell, MD
• Sara Louise Campbell, LPC
• Sarah Anne Campbell, DNP, AGAC-BC

• All providers in Fayetteville, AR
• In Home Supportive Care Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.