Individual provider Active NPI

Eric J Campbell, PA-C

  • Physician Assistant
  • Edmond, OK
National Provider Identifier
1861482887
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
17937 N Pennsylvania Ave Ste 201
Edmond, OK 73012-9001
Phone
(405) 260-8605
Fax
(405) 369-9310
NPI assigned
Oct 21, 2005
Last updated
Apr 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

17937 N Pennsylvania Ave Ste 201
Edmond, OK 73012-9001

Mailing address

2451 E Baseline Rd Ste 425
Gilbert, AZ 85234-0049
Phone (405) 260-8605

Other identifiers 1

IdentifierTypeStateIssuer
100138410BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20040715000134 OK Practitioner - Physician Assistant 7315926219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonhoeffer Rheumatology Institute LLCGroup PAC ID 1850601360, 10 clinicians

Practice addresses (Care Compare)

17937 N Pennsylvania Ave
Suite 201
Edmond, OK 73012-9001
Phone (405) 260-8605

2451 E Baseline Rd
Suite 425
Gilbert, AZ 85234-0049

Merit-based Incentive Payment System (MIPS)

Final score
74.12 of 100Reported as group
Quality
64.14
Promoting interoperability
75
Improvement activities
40
Cost
70.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
821OKMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Oklahoma Cardiovascular Surgery Assoc. Inc. Past Accepting new patients
Mercy Health Services Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Health Network Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1861482887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 E BASELINE RD STE 425",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852340049",
            "telephone_number": "405-260-8605",
            "fax_number": "405-369-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17937 N PENNSYLVANIA AVE STE 201",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129001",
            "telephone_number": "405-260-8605",
            "fax_number": "405-369-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100138410B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.