NPIMap

Organization Active NPI

Campbell Family Practice, P.a.

  • Rural Health Clinic/Center
  • Mullins, SC
National Provider Identifier
1871601039
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CAMPBELL FAMILY PRACTICE, P.A.
Practice address
2835 E Highway 76
Suite 6
Mullins, SC 29574-6038
Phone
(843) 431-9882
Fax
(843) 431-9879
NPI assigned
Aug 28, 2006
Last updated
Oct 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Authorized official

Name
Treadwell Campbell, M.D.NPI 1205939550
Title
Director/Owner
Phone
(843) 431-9882

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

2835 E Highway 76
Suite 6
Mullins, SC 29574-6038

Mailing address

PO Box 1033
Mullins, SC 29574-1033
Phone (843) 431-9882

Other identifiers 1

IdentifierTypeStateIssuer
RHC124MedicaidSC

Other names 1

  • Campbell Family Practice Other name

National Provider Directory

National Provider Directory

Locations

2835 E Highway 76
Ste 6
Mullins, SC 29574
Phone (843) 431-9882

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1871601039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1033",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295741033",
            "telephone_number": "843-431-9882",
            "fax_number": "843-431-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 E HIGHWAY 76",
            "address_2": "SUITE 6",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746038",
            "telephone_number": "843-431-9882",
            "fax_number": "843-431-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL FAMILY PRACTICE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "TREADWELL",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "843-431-9882",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC124",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campbell Family Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mullins, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.