Individual provider Active NPI

James William Campbell III, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Vidalia, GA
National Provider Identifier
1851935316
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN264107 Issued in GA
Practice address
121 Church St
Vidalia, GA 30474-4752
Phone
(912) 805-2705
NPI assigned
Oct 28, 2019
Last updated
Jan 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN264107 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN264107 GA Primary

Addresses

Primary practice location

121 Church St
Vidalia, GA 30474-4752

Mailing address

121 Church St
Vidalia, GA 30474-4752
Phone (912) 805-2705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200122003356 GA Practitioner - Nurse Practitioner 2567897424 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Southland Consolidated Emergency Services LLCGroup PAC ID 2860792066, 68 clinicians
Southland Optim Screven Emergency Medical Services LLCGroup PAC ID 9739480021, 19 clinicians

Practice addresses (Care Compare)

1067 Peachtree St
Louisville, GA 30434-1558
Phone (478) 625-7000

121 Church St
Vidalia, GA 30474-4752
Phone (912) 805-2705

215 Mims Rd
Sylvania, GA 30467-1994
Phone (912) 557-1207

400 Cedar St
Metter, GA 30439-3706
Phone (912) 685-5741

931 E Winthrope Ave
Millen, GA 30442-1839
Phone (912) 557-1207

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN264107GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Jan 26, 2021 Accepting new patients
Southland Emergency Medical Services Consolidated, LLC CurrentSince Nov 1, 2021 Accepting new patients
Southland Taylor Hospitalist Group, LLC CurrentSince Nov 1, 2025 Accepting new patients
Southland Consolidated Emergency Services, LLC CurrentSince Nov 1, 2021 Accepting new patients
Southland Optim Screven Emergency Medical Services LLC CurrentSince Jun 16, 2021 Accepting new patients
Anchored Minds Behavioral Health LLC Psychiatric/Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Southland Optim Jenkins Emergency Medical Services, LLC CurrentSince Jun 16, 2021 Accepting new patients
Hospital Authority of Candler County CurrentSince Mar 21, 2023 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Jan 26, 2021 Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Sep 18, 2024 Accepting new patients
Emergency Physicians Inc CurrentSince Nov 3, 2021 Accepting new patients
Southland Optim Jenkins Emergency Medical Services, LLC CurrentSince Jun 16, 2021 Accepting new patients
Hospital Authority of Candler County Current Accepting new patients
Hospital Authority of Candler County CurrentSince Mar 21, 2023 Accepting new patients
Southland Hawkinsville Emergency Medical Services, LLC CurrentSince Nov 1, 2025 Accepting new patients
Southland Evans Emergency Medical Services LLC Past Accepting new patients

Locations

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

222 Perry Hwy
Hawkinsville, GA 31036
Phone (229) 200-4950

1067 Peachtree St
Louisville, GA 30434
Phone (478) 625-7000

400 Cedar St
Metter, GA 30439
Phone (912) 685-1726

931 E Winthrope Ave
Millen, GA 30442
Phone (478) 982-4221

215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207

121 Church St
Vidalia, GA 30474
Phone (912) 537-7737

3193 E 1st St
Vidalia, GA 30474
Phone (912) 537-8588

120 Gordon St
Washington, GA 30673
Phone (706) 678-1177

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1851935316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CHURCH ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744752",
            "telephone_number": "912-805-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CHURCH ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744752",
            "telephone_number": "912-805-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN264107",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN264107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

Verify at the official NPI Registry.