Active NPI
Amanda Campbell, MSN, FNP-BC
- Family Nurse Practitioner
- Charleston, WV
National Provider Identifier
1962801340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN60245NP
- Practice address
- 3100 Maccorkle Ave SE Ste 205
Charleston, WV 25304-1228 - Phone
- (304) 720-7305
- Fax
- (304) 720-7310
- NPI assigned
- Aug 21, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN60245NP | WV | Primary |
Addresses
Primary practice location
3100 Maccorkle Ave SE Ste 205
Charleston, WV 25304-1228
Mailing address
3100 Maccorkle Ave SE Ste 205
Charleston, WV 25304-1228
Phone (304) 720-7305
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810027920 | Medicaid | WV |
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
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN60245NP | WV | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1962801340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 MACCORKLE AVE SE STE 205",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253041228",
"telephone_number": "304-720-7305",
"fax_number": "304-720-7310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 MACCORKLE AVE SE STE 205",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253041228",
"telephone_number": "304-720-7305",
"fax_number": "304-720-7310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "AMANDA",
"name_prefix": "Ms.",
"credential": "MSN, FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WV",
"license": "APRN60245NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810027920",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.