NPIMap

Individual provider Active NPI

Michelle June Campbell, APRN

  • Family Nurse Practitioner
  • Manchester, NH
National Provider Identifier
1861836116
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
031401-23 Issued in NH
Practice address
1 Elliot Way
Manchester, NH 03103-3502
Phone
(603) 663-3740
Fax
(603) 663-3749
NPI assigned
Apr 17, 2013
Last updated
Apr 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 031401-23 NH Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 031401-23 NH

Addresses

Primary practice location

1 Elliot Way
Manchester, NH 03103-3502

Mailing address

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 663-3740

Other names 1

  • Michelle June Kelly Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130705000223 NH Practitioner - Nurse Practitioner 3274773783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

25 Leavey Dr
Bedford, NH 03110-4437
Phone (603) 663-3740

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031401-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services Endocrinology, Diabetes & Metabolism CurrentSince May 31, 2016 Accepting new patients

Locations

25 Leavey Dr
Bedford, NH 03110
Phone (603) 472-5860

25 Leavey Dr
Unit 1
Bedford, NH 03110

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

Organizations & group practices 1

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.

Hospital & facility affiliations 7

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": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1861836116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-663-3740",
            "fax_number": "603-663-3749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-663-3740",
            "fax_number": "603-663-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MICHELLE",
        "middle_name": "JUNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "031401-23",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NH",
            "license": "031401-23",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "KELLY",
            "middle_name": "JUNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.