Individual provider Active NPI

Lynn B Campbell, R.D., C.D.E.

  • Registered Dietitian
  • Gastonia, NC
National Provider Identifier
1962515908
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L000681 Issued in NC
Practice address
111 E 3Rd Ave
Gastonia, NC 28052-4317
Phone
(704) 874-3300
Fax
(704) 874-0065
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L000681 NY
Registered Dietitian 133V00000X L000681 NC Primary

Addresses

Primary practice location

111 E 3Rd Ave
Gastonia, NC 28052-4317

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1900

Other practice location 1

4525 Cameron Valley Pkwy
Suite 4100
Charlotte, NC 28211-4369
Phone (704) 302-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041214000754 NC Practitioner - Registered Dietitian Or Nutrition Professional 0941267611 Reassigns benefits to 2 organizations
I20201104002522 VA Practitioner - Registered Dietitian Or Nutrition Professional 0941267611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gaston Family Health Services IncGroup PAC ID 5496733925, shared by 94 NPIs, 98 clinicians

Practice addresses (Care Compare)

420 N Salisbury St
Lexington, NC 27292-3548
Phone (336) 249-6215

609 N Highland St
Gastonia, NC 28052-2179
Phone (704) 772-4700

991 W Hudson Blvd
Gastonia, NC 28052-6430
Phone (704) 853-5079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
842SCMDPediatric Dentist
L000681NCMDRegistered Dietitian
L000681NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Lwell LLC Dietitian, Registered CurrentSince Sep 15, 2020 Accepting new patients

Locations

711 N DeKalb St
Shelby, NC 28150
Phone (704) 482-1482

1309 Jamestown Rd
Ste 102
Williamsburg, VA 23185
Phone (757) 220-4917

Interoperability endpoints

  • Direct secure messaging: lcampbell351882@direct.ochin.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1962515908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 3RD AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524317",
            "telephone_number": "704-874-3300",
            "fax_number": "704-874-0065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Suite 4100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114369",
            "country_code": "US",
            "telephone_number": "704-302-9300",
            "fax_number": "704-302-9301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "LYNN",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "R.D., C.D.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "L000681",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L000681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.