Gary Lee Campbell Jr., ARNP, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Debary, FL
NPI 1790295582 · NPPES record last updated Jul 9, 2024
Key facts
- NPI
- 1790295582
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 9249219 (FL)
- Practice address
- 50 Spring Vista Dr
Debary, FL 32713 - Phone
- (386) 748-3900
- NPI assigned
- Oct 5, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ability Health Services, Inc
Ability Health Services and Rehabilitation LP
Practice addresses (Care Compare)
1200 Lexington Green LN
Sanford, FL 32771-1013
Hospital & facility affiliations
- Adventhealth Fish Memorial
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180214002484 | FL | Practitioner - Nurse Practitioner | 4688934565 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9249219 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohana Health P.a. | Current |
Accepting new patients | |
| Spahana Health, Inc. | Past |
Accepting new patients |
Locations
50 Spring Vista Dr
Debary, FL 32713
Phone (386) 279-3087
Interoperability endpoints
- gary.campbell.1@19139.direct.athenahealth.com
- https://api.platform.athenahealth.com/19139/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9249219 | FL | Yes |
Addresses
Primary practice location
50 Spring Vista Dr
Debary, FL 32713
Mailing address
50 Spring Vista Dr
Debary, FL 32713-1809
Phone (386) 279-3087
Other providers in Debary, FL
- Jennifer Brow
- Shad M Brown
- Addison Page Burkholder
- Joseph V Calderone Jr.
- Ruth Elizabeth Caldwell
- Dana Louise Cannon
- Patricia Case
- Jessica Lynn Causey
- Celebration Orthopedic and Sports Medicine Institute Inc
- Central Florida Chronic Care Management Group
All providers in Debary, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.