Marie Campbell, FNP-BC

Individual provider Active NPI Family Nurse Practitioner · Moorpark, CA

NPI 1841476801 · NPPES record last updated Oct 26, 2022

Key facts

NPI
1841476801
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
17539 (CA)
Practice address
145 Park LN
Suite 120
Moorpark, CA 93021-2113
Phone
(805) 552-0001
NPI assigned
Jan 21, 2008
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20090217000409 CA Practitioner - Nurse Practitioner 6305901893 Reassigns benefits to 4 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17539CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Los Robles Emergency Physicians Medical Group Current
since Apr 14, 2016
Accepting new patients
Southern California Permanente Medical Group Current
since Aug 15, 2022
Accepting new patients
Southern California Permanente Medical Group Current
since Aug 15, 2022
Accepting new patients
West Hills Emergency Medical Associates, Inc Current
since Dec 17, 2014
Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Huntington Park Emergency Physicians, Inc Current
since Nov 1, 2013
Accepting new patients
Morin Medical Corp. Past Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

2623 E Slauson Ave
Walnut Park, CA 90255
Phone (323) 277-5855

7300 Medical Ctr
West Hills, CA 91307
Phone (818) 612-8301

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17539 CA Yes

Addresses

Primary practice location

145 Park LN
Suite 120
Moorpark, CA 93021-2113

Mailing address

145 Park LN
Suite 120
Moorpark, CA 93021-2113
Phone (805) 552-0001

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Other providers in Moorpark, CA

All providers in Moorpark, CA · Family Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.