Matthew Warren Campbell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

43-695 Issued in MS

Practice address

2005 Harris Dr
Oxford, MS 38655-4222

Phone

(662) 513-9936

Fax

(662) 513-9937

NPI assigned

Jul 21, 2006

Last updated

Dec 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Magnolia Counseling

  • Specialist
  • Batesville, MS
  • NPI 1891919668
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1790706398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 HARRIS DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386554222",
            "telephone_number": "662-513-9936",
            "fax_number": "662-513-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 HARRIS DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386554222",
            "telephone_number": "662-513-9936",
            "fax_number": "662-513-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MATTHEW",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "43-695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08079804",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deidre L Callicut
• Camellia Hospice of North Mississippi, LLC (Enhabit Hospice of North Mississippi)
• Campbell Clinic PC
• Jerold Campbell
• Mark Edward Campbell, M.D.
• Mia Desirae Campbell
• Tori Ashanti Campbell, BSW
• John E Cantrell, M.D.
• Dian Parker Capps, M.ED.
• Jordan Jackson Caracci, DMD

• Clinical Psychologist in Oxford, MS
• Providers in Oxford, MS by specialty
• Clinical Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.