Grant McKenzie Campbell, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A193270 Issued in CA

Practice address

10004 Foothills Blvd
Roseville, CA 95747-7102

Phone

(916) 435-2700

Fax

(916) 435-2701

NPI assigned

Apr 22, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 22, 2026 through Feb 22, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1861074510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 W UNDERWOOD ST STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "321-841-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 FOOTHILLS BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957477102",
            "telephone_number": "916-435-2700",
            "fax_number": "916-435-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "GRANT",
        "middle_name": "MCKENZIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A193270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pietro Salvatore Caminiti, DC
• Sharifa Danila Cammack
• Camille Camoro
• Benjamin Campbell, D.O.
• Christopher L Campbell, D.O.
• Katherine M Campbell, M.A.
• Matthew Campbell
• Trevor David Campbell, DO
• Jasmin Campos
• Campus Commons Physical Therapy

• Internal Medicine Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.