Shelly Ann Ethel Campbell

Primary specialty

SpecialistTaxonomy code 174400000X

License

1218251181 Issued in NY

Practice address

1017 Winthrop St Apt 3
Brooklyn, NY 11212-1404

Phone

(347) 869-5051

NPI assigned

Jan 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1972133833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 WINTHROP ST APT 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112121404",
            "telephone_number": "347-869-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 WINTHROP ST APT 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112121404",
            "telephone_number": "347-869-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "SHELLY ANN",
        "middle_name": "ETHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "1218251181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Campbell, LPN
• Ruslana Campbell, MS.ED.SP.ED
• Shani Campbell
• Sharon Campbell
• Shauna Campbell
• Simyra Campbell
• Susan Adams Campbell, OTR
• Tyra Ashley Campbell
• Waynenika Campbell, APRN, FNP
• Wendy Campbell

• Specialist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.