NPIMap

Individual provider Active NPI

Colin Stuart Campbell, NP-C

  • Family Nurse Practitioner
  • Warsaw, MO
National Provider Identifier
1912595778
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020033730 Issued in MO
Practice address
1771 Commercial St
Warsaw, MO 65355-3096
Phone
(660) 438-5193
NPI assigned
Jan 7, 2021
Last updated
Mar 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 66030 NM
Family Nurse Practitioner 363LF0000X 214523 AR
Family Nurse Practitioner 363LF0000X 5380251102 KS
Family Nurse Practitioner 363LF0000X 2020033730 MO Primary

Addresses

Primary practice location

1771 Commercial St
Warsaw, MO 65355-3096

Mailing address

2205 W Auburn St
Bolivar, MO 65613-3205
Phone (417) 399-3643

Other practice location 1

2205 W Auburn St
Bolivar, MO 65613-3205
Phone (417) 399-3643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210226001820 MO Practitioner - Nurse Practitioner 7315352705 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

3817 S Springfield Ave
140 Sgfmc Senior Focus Bolivar
Bolivar, MO 65613-9129
Phone (417) 422-4769

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5380251102KSMDFamily Nurse Practitioner
66030NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Memorial Hospital District CurrentSince Jan 17, 2022 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince May 12, 2025 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince May 12, 2025 Accepting new patients
Golden Valley Memorial Hospital District Current Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Jan 17, 2022 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince May 12, 2025 Accepting new patients

Locations

3817 S Springfield Ave
Ste 140
Bolivar, MO 65613
Phone (417) 422-4769

1600 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Organizations & group practices 6

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

Hospital & facility affiliations 9

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": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1912595778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 W AUBURN ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133205",
            "telephone_number": "417-399-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 COMMERCIAL ST",
            "city": "WARSAW",
            "state": "MO",
            "postal_code": "653553096",
            "telephone_number": "660-438-5193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 W Auburn St",
            "address_purpose": "LOCATION",
            "city": "Bolivar",
            "state": "MO",
            "postal_code": "656133205",
            "country_code": "US",
            "telephone_number": "417-399-3643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "COLIN",
        "middle_name": "STUART",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-07",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "66030",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "214523",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5380251102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020033730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, MO

Sources for this page

Verify at the official NPI Registry.