Tanner Ray Campbell, MD
Individual provider Active NPI Pediatric Orthopaedic Surgery Physician · Aledo, TX
NPI 1821593096 · NPPES record last updated Sep 10, 2024
Key facts
- NPI
- 1821593096
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Orthopaedic Surgery Physician 207XP3100X
- License
- V1421 (TX)
- Practice address
- 13340 Highland Hills Dr Ste 112
Aledo, TX 76008-2000 - Phone
- (682) 303-3000
- Fax
- (682) 303-3026
- NPI assigned
- Mar 28, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cook Childrens Physician Network
Practice addresses (Care Compare)
1500 Cooper St
Fort Worth, TX 76104-2710
Phone (682) 885-4007
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240828002761 | TX | Practitioner - Orthopedic Surgery |
4587912134 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A186813 | CA | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook Children'S Physician Network | Current | Accepting new patients | |
| Cook Children'S Physician Network | Current |
Accepting new patients | |
| Cook Children'S Medical Center | Past |
Accepting new patients |
Locations
13340 Highland Hills Dr
Ste 112
Aledo, TX 76008
Phone (682) 303-3000
7000 Calmont Ave
Ste 150
Fort Worth, TX 76116
Phone (682) 885-6163
801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054
1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500
136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412
Interoperability endpoints
- tcampbell215507@cookchildrens.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | A186813 | CA | |
| Pediatric Orthopaedic Surgery Physician | 207XP3100X | V1421 | TX | Yes |
Addresses
Primary practice location
13340 Highland Hills Dr Ste 112
Aledo, TX 76008-2000
Mailing address
PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tcampbell215507@CookChildrens.direct-ci.com |
Other providers in Aledo, TX
- Jennifer Ann Briscoe
- Shannon A Bruno-Scoggins
- Jacey Layne Bullock
- Emma Bundy
- Lauren Michelle Cagle
- Cynthia Carroll
- Brooke Carter
- Child Psychological Services
- Stacy R Cliver
- Clover Oxygen PLLC
All providers in Aledo, TX · Pediatric Orthopaedic Surgery Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2024. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.