Individual provider Active NPI

Caitlin Jean Campbell, O.D.

  • Optometrist
  • Durango, CO
National Provider Identifier
1942432976
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2948 Issued in CO
Practice address
2855 N Main
Ste A103
Durango, CO 81301
Phone
(970) 382-8790
Fax
(970) 382-8966
NPI assigned
Aug 9, 2009
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Optometry
Education
Pacific University - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
3 Rivers Eyecare LLC (2 clinicians)

Practice addresses (Care Compare)

700 S Ave W
Suite G
Missoula, MT 59801-8011
Phone (406) 549-4851

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CO, MT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130923000217 CO Practitioner - Optometry 8325282916 Reassigns benefits to 1 organization
I20150429000931 MT Practitioner - Optometry 8325282916 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2948COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
3 Rivers Eyecare LLC Optometrist Current
since Dec 8, 2014
Accepting new patients
Envision Durango LLC Optometrist Current
since Jan 4, 2013
Accepting new patients
Sandy Sheppard OD PC Optometrist Past
since Dec 8, 2014
Accepting new patients

Locations

2977 Main Ave
Ste A
Durango, CO 81301
Phone (970) 382-8790

2855 Main Ave
Ste A103
Durango, CO 81301
Phone (970) 382-8790

700 South Ave W
Missoula, MT 59801
Phone (406) 549-4851

700 South Ave W
Ste G
Missoula, MT 59801
Phone (406) 549-4851

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 2948 CO
Optometrist 152W00000X 2948 CO Primary

Addresses

NPPES NPI Registry

Primary practice location

2855 N Main
Ste A103
Durango, CO 81301

Mailing address

2855 N Main
Ste A103
Durango, CO 81301
Phone (970) 382-8790

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 5, 2013.

{
    "created_epoch": "1249776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1942432976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 N MAIN",
            "address_2": "STE A103",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81301",
            "telephone_number": "970-382-8790",
            "fax_number": "970-382-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 N MAIN",
            "address_2": "STE A103",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81301",
            "telephone_number": "970-382-8790",
            "fax_number": "970-382-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CAITLIN",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-09",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CO",
            "license": "2948",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.