Mary Ellen Campobasso, ACNS-BC

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

COA02675-NS Issued in OH

Practice address

18697 Bagley Rd
Middleburg Heights, OH 44130-3417

Phone

(440) 816-8000

NPI assigned

Sep 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MHSP,Inc

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023049723
  NPD (past)

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1871802587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30680 BAINBRIDGE RD",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392282",
            "telephone_number": "440-542-5023",
            "fax_number": "440-542-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOBASSO",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "ACNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "COA02675-NS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexus Ann Bushee
• Mary Logan Butcher
• Collin M Butler
• Joshua William Buzzard, MD
• Cambridge Home Health Care Inc
• Carol Manders Cardello, CNS APRN BC
• Cardiovascular Medicine Associates, Inc.
• Mildred Cardona, MD
• Care Dental
• Caretenders of Cleveland, Inc Dba Almost Family - Medlink

• Adult Health Clinical Nurse Specialist in Middleburg Heights, OH
• Providers in Middleburg Heights, OH by specialty
• Adult Health Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.