Kimberly Jordan Campbell, M.D.
Individual provider Active NPI Family Medicine Physician · Lewiston, ID
NPI 1861669988 · NPPES record last updated Dec 2, 2024
Key facts
- NPI
- 1861669988
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M11531 (ID)
- Practice address
- 1203 Idaho St
Lewiston, ID 83501-1940 - Phone
- (509) 444-8200
- NPI assigned
- May 8, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 25
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health Association of Spokane
Practice addresses (Care Compare)
1203 Idaho St
Lewiston, ID 83501-1940
Phone (208) 848-8300
803 S Main St
Suite 120
Moscow, ID 83843-2695
Phone (208) 848-8300
Hospital & facility affiliations
- St Joseph Regional Medical Center
- Tri-State Memorial Hospital
- Clearwater Valley Hospital & Clinics
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120109000878 | ID | Practitioner - Family Practice | 9436205762 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M11531 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Association of Spokane | Current | Accepting new patients | |
| Community Health Association of Spokane | Current |
Accepting new patients | |
| Community Health Association of Spokane | Current |
Accepting new patients | |
| Community Health Association of Spokane | Past | Accepting new patients |
Locations
1203 Idaho St
Lewiston, ID 83501
Phone (208) 848-8300
803 S Main St
Ste 120
Moscow, ID 83843
Phone (208) 848-8300
611 N Iron Bridge Way
Spokane, WA 99202
Interoperability endpoints
- kimcampbell@syringahospital.cernerdirect.com
- kimberly.campbell.1@11411.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M11531 | ID | Yes |
Addresses
Primary practice location
1203 Idaho St
Lewiston, ID 83501-1940
Mailing address
611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01-37459 | Other | MEDICA | |
| 1861669988 | Other | MN | BCBS |
| 1861669988 | Other | GROUP HEALTH | |
| 1861669988 | Other | ID | REGENCE BLUE SHIELD |
| 1861669988 | Medicaid | MN | |
| P00767193 | Other | MEDICARE RAILROAD | |
| 1861669988 | Medicaid | ID |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kimcampbell@syringahospital.cernerdirect.com | Direct |
Other providers in Lewiston, ID
- Taryn Cadez-Schmidt
- Kathryn K Calkins
- Roger Jeffrey Call
- Camas Service Coordination, Inc.
- Brittany Campbell
- Shannon D Campbell
- Lillian Francine Caradine
- Natale Carasali
- Haley Cardenas
- Care Center (Lewiston) Inc.
All providers in Lewiston, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.