Individual provider Active NPI

Camry Danielle Campbell, FNP-C

  • Nurse Practitioner
  • Greenville, MS
National Provider Identifier
1891363081
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904696 Issued in MS
Practice address
1502 S Colorado St
Greenville, MS 38703-7219
Phone
(662) 332-9872
Fax
(662) 332-9878
NPI assigned
Jun 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 904696 MS Primary

Addresses

Primary practice location

1502 S Colorado St
Greenville, MS 38703-7219

Mailing address

1502 S Colorado St
Greenville, MS 38703-7219
Phone (662) 332-9872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20210630002473 MS Practitioner - Nurse Practitioner 3870994635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Greenville Clinic 8 clinicians

Practice addresses (Care Compare)

1502 S Colorado St
Greenville, MS 38703-7219
Phone (662) 332-9872

Hospital & facility affiliations

  • Arden Home Health of West Ms, LLC Home health agency, Ridgeland, MS, CCN 257115
  • Delta Health-the Medical Center Home health agency, Greenville, MS, CCN 257098
  • Vitalcaring Group Home health agency, Cleveland, MS, CCN 257016
  • Delta Health System - the Medical Center Hospital, Greenville, MS, CCN 250082

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Greenville Clinic CurrentSince Aug 2, 2021 Accepting new patients
Dr Joseph R Terracina, MD, PA CurrentSince Jun 24, 2021 Accepting new patients
Integrated Dermatology Group, LLC PastSince Jun 1, 2021 Accepting new patients

Locations

2525 Highway 1 S
Ste A
Greenville, MS 38701
Phone (662) 335-1103

1502 S Colorado St
Greenville, MS 38703
Phone (601) 332-9872

Interoperability endpoints

  • Direct secure messaging: camrycampbell@tgcpa.allscriptsdirect.net

Organizations & group practices 3

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.

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": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1891363081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 S COLORADO ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037219",
            "telephone_number": "662-332-9872",
            "fax_number": "662-332-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S COLORADO ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037219",
            "telephone_number": "662-332-9872",
            "fax_number": "662-332-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CAMRY",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.