Individual provider Active NPI

Bart Anthony Campolo

  • Professional Counselor
  • Cincinnati, OH
National Provider Identifier
1790301265
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2002524 Issued in OH
Practice address
830 Ezzard Charles Dr
Cincinnati, OH 45214-2525
Phone
(513) 381-6672
NPI assigned
Jun 22, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2002524 OH Primary

Addresses

Primary practice location

830 Ezzard Charles Dr
Cincinnati, OH 45214-2525

Mailing address

1844 Fairfax Ave
Cincinnati, OH 45207-1812
Phone (513) 404-2431

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

LicenseStateTypeSpecialty
2002524OHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1790301265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 FAIRFAX AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452071812",
            "telephone_number": "513-404-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 EZZARD CHARLES DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452142525",
            "telephone_number": "513-381-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOLO",
        "first_name": "BART",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "2002524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.