Shannon Lee Campbell, AGACNP-BC
Individual provider Active NPI Adult Health Nurse Practitioner · Clyde, TX
NPI 1871004358 · NPPES record last updated Nov 15, 2022
Key facts
- NPI
- 1871004358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- AP135592 (TX)
- Practice address
- 102 Archer St
Clyde, TX 79510-4225 - Phone
- (325) 893-1010
- Fax
- (325) 893-1442
- NPI assigned
- Oct 23, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hospitalist Physicians of Massachusetts PC
Big Bend Medical Group
Hospitalist Physicians of New Jersey PA
Hospitalist Physicians of Indiana PC
Practice addresses (Care Compare)
123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-9394
1608 W FM
Big Spring, TX 79720-4113
1608 W FM 700
Big Spring, TX 79720-4113
520 E 6TH St
Odessa, TX 79761-4527
Phone (432) 582-8535
727 N Beers St
Holmdel, NJ 07733-1514
Phone (732) 739-5900
7950 W Jefferson Blvd
Lutheran Hospital of Indiana
Fort Wayne, IN 46804-4140
Phone (260) 435-7001
Hospital & facility affiliations
- Bayshore Medical Center
- Odessa Regional Medical Center
- St Vincent Hospital
- Raritan Bay Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (5 enrollments) in TX, IN, NJ, MA, PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180419002284 | TX | Practitioner - Nurse Practitioner | 2062775364 | Reassigns benefits to 7 organizations |
| I20231102002750 | IN | Practitioner - Nurse Practitioner | 2062775364 | Reassigns benefits to 1 organization |
| I20241230001556 | NJ | Practitioner - Nurse Practitioner | 2062775364 | Reassigns benefits to 1 organization |
| I20250825002857 | MA | Practitioner - Nurse Practitioner | 2062775364 | Reassigns benefits to 1 organization |
| I20250902003150 | PA | Practitioner - Nurse Practitioner | 2062775364 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP135592 | TX | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Physicians of Massachusetts PC | Current |
Accepting new patients | |
| Lonestar Hospital Medicine Associates, PA | Current |
Accepting new patients | |
| Concord Medical Group PLLC | Current |
Accepting new patients | |
| Comprehensive Hospitalist Services of Texas PLLC | Current |
Accepting new patients | |
| Hospitalist Physicians of New Jersey PA | Current |
Accepting new patients | |
| Hospitalist Physicians of Indiana, PC | Current |
Accepting new patients | |
| Big Bend Medical Group | Current |
Accepting new patients | |
| Pennsylvania HM Associates PC | Current |
Accepting new patients | |
| Hospitalist Medicine Physicians of Texas, PLLC | Current |
Accepting new patients | |
| Comprehensive Hospitalist Services of Texas PLLC | Current |
Accepting new patients | |
| Cogent Healthcare of Texas, PA | Current |
Accepting new patients | |
| Concord Medical Group of Texas PLLC | Current |
Accepting new patients | |
| Big Bend Medical Group | Current |
Accepting new patients |
Locations (25 of 27)
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088
7952 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2999
1850 State St
New Albany, IN 47150
Phone (812) 944-7701
123 Summer St
Worcester, MA 01608
Phone (508) 363-6000
300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460
65 James St
Edison, NJ 08820
Phone (732) 321-7010
727 N Beers St
Holmdel, NJ 07733
Phone (732) 714-2700
530 New Brunswick Ave
Perth Amboy, NJ 08861
Phone (732) 324-5007
206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951
334 Main St
Scranton, PA 18519
Phone (570) 307-1767
601 E 15th St
Austin, TX 78701
Phone (512) 324-7868
1608 W FM 700
Ste C
Big Spring, TX 79720
Phone (432) 263-7700
200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241
600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511
5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263
3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800
1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431
1310 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-2273
310 W South St
Henrietta, TX 76365
Phone (806) 647-2191
7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000
18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409
850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900
520 E 6th St
Odessa, TX 79761
Phone (432) 332-0929
7101 Eastridge Rd
Odessa, TX 79765
Phone (432) 550-0048
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | AP135592 | TX | Yes |
Addresses
Primary practice location
102 Archer St
Clyde, TX 79510-4225
Mailing address
102 Archer St
Clyde, TX 79510-4225
Phone (325) 893-1010
Other providers in Clyde, TX
- Aaron Ashlock
- Kathi Iula Ashlock
- Rosa L Best
- Big Country Transportation Services
- Callahan County Health and Wellness Clinic PLLC
- Randall Carlton
- Billy W. Carpenter
- Margarette Jean Chaney
- Citizens Emergency Medical Service
- Citizens Emergency Medical Service Inc.
All providers in Clyde, TX · Adult Health Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2022. 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.