Steven Sean Campbell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA07922 Issued in TX

Practice address

546 W Seminary Dr Ste a
Fort Worth, TX 76115-1361

Phone

(817) 924-7978

NPI assigned

Sep 6, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iberia Medical Clinic, P.a.Group PAC ID 7911981600, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Iberia Medical Clinic, P.a.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1043331812

  TX

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1891044780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 W SEMINARY DR STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151361",
            "telephone_number": "817-924-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 W SEMINARY DR STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151361",
            "telephone_number": "817-924-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "STEVEN",
        "middle_name": "SEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3470148-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Eve Campbell, M.S. CCC-SLP
• Robert Lee Campbell, D.O.
• Rowan Stewart Campbell, MD
• Shannon Kohlenberg Campbell, LCSW
• Stefani Mary Campbell
• Titia Campbell, LMT
• Darius Dexter Campinha-Bacote, PSY.D.
• Daisy Campos
• Joel Campos
• Can Ho Enterprise

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.