Active NPI
Campbell Karl Schulstad, MD
- Surgery Physician
- Cynthiana, KY
National Provider Identifier
1902966161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 30180
- Practice address
- 1210 Ky Highway 36 E
Suite 1D
Cynthiana, KY 41031-7490 - Phone
- (859) 234-1707
- Fax
- (859) 234-1768
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 30180 | KY | Primary |
Addresses
Primary practice location
1210 Ky Highway 36 E
Suite 1D
Cynthiana, KY 41031-7490
Mailing address
1210 Ky Highway 36 E
Suite G3
Cynthiana, KY 41031-7490
Phone (859) 235-3638
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64018039 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30180 | KY | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434931200000",
"number": "1902966161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 KY HIGHWAY 36 E",
"address_2": "SUITE G3",
"city": "CYNTHIANA",
"state": "KY",
"postal_code": "410317490",
"telephone_number": "859-235-3638",
"fax_number": "859-235-3536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 KY HIGHWAY 36 E",
"address_2": "SUITE 1D",
"city": "CYNTHIANA",
"state": "KY",
"postal_code": "410317490",
"telephone_number": "859-234-1707",
"fax_number": "859-234-1768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULSTAD",
"first_name": "CAMPBELL",
"middle_name": "KARL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2015-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "30180",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64018039",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cynthiana, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.