Individual provider Active NPI

Heather Causey Campbell, FNP

  • Nurse Practitioner
  • Conway, SC
National Provider Identifier
1821528571
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
20998 Issued in SC
Practice address
1113 Church St
Conway, SC 29526-4128
Phone
(843) 248-6269
NPI assigned
Jun 15, 2017
Last updated
Jun 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 20998 SC Primary

Addresses

Primary practice location

1113 Church St
Conway, SC 29526-4128

Mailing address

1720 Daisy Rd
Loris, SC 29569-7048
Phone (843) 601-3929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171208001791 SC Practitioner - Nurse Practitioner 3870850357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Carenow Urgent Care LLCGroup PAC ID 3274893359, 72 clinicians

Practice addresses (Care Compare)

9820 N Kings Hwy
Myrtle Beach, SC 29572-4013
Phone (843) 497-2273

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20998SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Carenow Urgent Care, LLC CurrentSince Nov 27, 2021 Accepting new patients
Beach Urgent Care CurrentSince Nov 27, 2021 Accepting new patients

Locations

515 Saint James Ave
Goose Creek, SC 29445
Phone (843) 507-8925

9820 N Kings Hwy
Myrtle Beach, SC 29572
Phone (843) 449-2273

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1821528571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 DAISY RD",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295697048",
            "telephone_number": "843-601-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 CHURCH ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264128",
            "telephone_number": "843-248-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "HEATHER",
        "middle_name": "CAUSEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "20998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.