Scott Wells Campbell, O.D.
Individual provider Active NPI Optometrist · Galax, VA
NPI 1801978200 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801978200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 0618000022 (VA)
- Practice address
- 609 Glendale Rd
Galax, VA 24333-2209 - Phone
- (276) 236-3242
- Fax
- (276) 236-3250
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100512000210 | VA | Practitioner - Optometry | 3375671308 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0618000022 | VA | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618000022 | VA | Yes |
Addresses
Primary practice location
609 Glendale Rd
Galax, VA 24333-2209
Mailing address
609 Glendale Rd
Galax, VA 24333-2209
Phone (276) 236-3242
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42679 | Other | VA | DAVIS VISION |
| 9205551 | Medicaid | VA | |
| 117070 | Other | VA | EYE MED |
| 1054850001 | Other | VA | ADMINASTAR |
| 217722 | Other | VA | ANTHEM |
Other providers in Galax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.