Leslie A Campbell, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

101554 Issued in AK

Practice address

725 2ND Ave
Fairbanks, AK 99701-4450

Phone

(907) 347-2934

Fax

(907) 459-8201

NPI assigned

Feb 22, 2016

Last updated

Feb 22, 2016By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

Practice roles

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.

• Shiatsu Therapy LLC

  • Massage Therapist
  • Fairbanks, AK
  • NPI 1588023238
  NPD (past) Authorized official

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1831558584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74612",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997074612",
            "telephone_number": "907-347-2934",
            "fax_number": "907-459-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 2ND AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014450",
            "telephone_number": "907-347-2934",
            "fax_number": "907-459-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "LESLIE",
        "middle_name": "A",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "101554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ALASKA",
            "identifier": "101554",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Gayle Calvert
• Michaela Cameron
• Katherine E Cammack, PNP
• Brittany Ann Cammon
• Colin Emile Stafford Campbell, DPT
• Michael Campbell
• Raymond Campbell
• Sierra N Campbell
• Ted Campbell
• Charlotte Anne Cannon, CCC SLP

• Massage Therapist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.