Amanda Beth Campbell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

18638 Issued in TN

Practice address

105 W Stone Dr Ste 2B
Kingsport, TN 37660-3365

Phone

(423) 578-1595

Fax

(423) 578-1596

NPI assigned

Jun 15, 2014

Sex

Female

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 TN

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
• Indian Path Community Hospital Hospital, Kingsport, TN, CCN 440176

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amandacampbell@hmgpath.allscriptsdirect.net

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.

• Holston Medical Group PC

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1831110667
  Medicare reassignment Care Compare group NPD
• Endoscopy Center of Kingsport

  • Endoscopy Clinic/Center
  • Kingsport, TN
  • NPI 1235140385
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain States Health Alliance

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1992813240
  Care Compare affiliation
• Wellmont Health System

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation
• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation

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

{
    "created_epoch": "1402790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1831503184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W STONE DR STE 2B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-578-1595",
            "fax_number": "423-578-1596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2204 Pavilion Dr Ste 108",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604651",
            "country_code": "US",
            "telephone_number": "423-392-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "AMANDA",
        "middle_name": "BETH",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-15",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009661",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Calladerm LLC
• Stephanie Calmo-Rojas, PTA
• Mary Elizabeth Calvert, MED
• Sindy Camelo, FNP-BC
• Camelot Care Centers
• Tricia Cannon, PMHNP-BC
• David Charles Cantor, PSY.D.
• Melissa A Caravello, M.S., CCC-SLP
• Cardiovascular Associates, PC
• Patricia Nicole Cardwell, MA

• Family Nurse Practitioner in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.