Amy Calvert Campbell, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R881049 Issued in MS

Practice address

2080 S Frontage Rd Ste 112
Vicksburg, MS 39180-5882

Phone

(601) 883-6304

Fax

(601) 883-6325

NPI assigned

May 16, 2011

Last updated

Mar 27, 2023By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Vicksburg Clinic LLC

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1790711158
  NPD
• Revitalize Hydration Therapy, LLC

  • Gerontology Nurse Practitioner
  • Flowood, MS
  • NPI 1285261123
  NPD (past)
• Vicksburg Clinic LLC

  • Infectious Disease Physician
  • Vicksburg, MS
  • NPI 1659307791
  NPD (past)
• Vicksburg Hma Physician Management LLC

  dba Medical Associates of Vicksburg

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1437416351
  NPD (past)

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1770876377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649113",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752649113",
            "telephone_number": "855-343-5763",
            "fax_number": "855-343-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S FRONTAGE RD STE 112",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805882",
            "telephone_number": "601-883-6304",
            "fax_number": "601-883-6325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "823 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Yazoo City",
            "state": "MS",
            "postal_code": "391943233",
            "country_code": "US",
            "telephone_number": "662-751-8246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Highway 12 W",
            "address_purpose": "LOCATION",
            "city": "Kosciusko",
            "state": "MS",
            "postal_code": "390903208",
            "country_code": "US",
            "telephone_number": "662-289-4311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114 Byram Business Center Dr",
            "address_purpose": "LOCATION",
            "city": "Byram",
            "state": "MS",
            "postal_code": "392729636",
            "country_code": "US",
            "telephone_number": "601-376-9960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Stone Creek Blvd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392328210",
            "country_code": "US",
            "telephone_number": "601-420-2040",
            "fax_number": "601-420-2356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "AMY",
        "middle_name": "CALVERT",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "R881049",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R881049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R881049",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gloria J Butler, MD
• Katrina M Butler, LMSW
• Warner Buxton
• Cal-Med LLC
• Leah Jones Calder, PA-C
• Robert Michael Cannon, M.D.
• Carehaven Support Services, LLC
• Caring Hands Ppec of Vicksburg
• Chaney Carlucci, LPC
• James Henry Carr, M.D.

• Family Nurse Practitioner in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.