Active NPI
Raymond G Campbell, PTA
- Specialist
- Luling, LA
National Provider Identifier
1770715971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- A7469
- Practice address
- 12371 Highway 90
Suite D
Luling, LA 70070-2371 - Phone
- (985) 331-1001
- Fax
- (985) 331-1005
- NPI assigned
- Aug 20, 2009
- Last updated
- Aug 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A7469 | LA | Primary |
Addresses
Primary practice location
12371 Highway 90
Suite D
Luling, LA 70070-2371
Mailing address
12371 Highway 90
Suite D
Luling, LA 70070-5114
Phone (985) 331-1001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A7469 | LA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Region Rehab, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1770715971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12371 HIGHWAY 90",
"address_2": "SUITE D",
"city": "LULING",
"state": "LA",
"postal_code": "700705114",
"telephone_number": "985-331-1001",
"fax_number": "985-331-1005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12371 HIGHWAY 90",
"address_2": "SUITE D",
"city": "LULING",
"state": "LA",
"postal_code": "700702371",
"telephone_number": "985-331-1001",
"fax_number": "985-331-1005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "RAYMOND",
"middle_name": "G",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-20",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "LA",
"license": "A7469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Luling, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.