Individual provider Active NPI

Chad Ervin Campbell, D.O.

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1811017999
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS16049 Issued in FL
Practice address
690 S Goldenrod Rd
Orlando, FL 32822-8108
Phone
(407) 792-1144
Fax
(407) 232-9807
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 005242 AZ
Pediatrics Physician 208000000X 005242 AZ
Internal Medicine Physician 207R00000X OS16049 FL Primary

Addresses

Primary practice location

690 S Goldenrod Rd
Orlando, FL 32822-8108

Mailing address

515 W State Road 434 Ste 306
Longwood, FL 32750-5163
Phone (407) 541-0868

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190913000673 FL Practitioner - Internal Medicine 3476685041 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS16049FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Dec 1, 2020 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 1, 2020 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC Current Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Aug 1, 2022 Accepting new patients
Orlando Physicians Network Inc Internal Medicine CurrentSince Apr 20, 2021 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Aug 1, 2022 Accepting new patients
Desert Valley Radiology, PLC Past Accepting new patients

Locations

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

515 W State Road 434
Ste 306
Longwood, FL 32750
Phone (407) 541-0864

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

690 S Goldenrod Rd
Orlando, FL 32822
Phone (407) 628-6117

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

1600 Budinger Ave
Ste D
Saint Cloud, FL 34769
Phone (407) 826-3006

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1811017999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W STATE ROAD 434 STE 306",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505163",
            "telephone_number": "407-541-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S GOLDENROD RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228108",
            "telephone_number": "407-792-1144",
            "fax_number": "407-232-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CHAD",
        "middle_name": "ERVIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "005242",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "005242",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS16049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.