Ralph P Campanale II, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M4961 Issued in ID

Practice address

180 W First Street Suite 301
Ketchum, ID 83340

Phone

(208) 726-3707

Fax

(208) 726-4817

NPI assigned

Apr 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ralph P Campanale MD PC

  • Specialist
  • Ketchum, ID
  • NPI 1114194586
  Authorized official Same address or phone
• Gene D Branum PC

  • Surgery Physician
  • Ketchum, ID
  • NPI 1164937496
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972566727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 777",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838160777",
            "telephone_number": "208-772-5882",
            "fax_number": "208-762-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W FIRST STREET SUITE 301",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "83340",
            "telephone_number": "208-726-3707",
            "fax_number": "208-726-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPANALE",
        "first_name": "RALPH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M4961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020024438",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ID",
            "identifier": "D3513",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010000420",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002699100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Brown, PA-C
• Katherine Mary Buckley, MD
• Anthony Maisin Buoncristiani, M.D.
• Tracey L Busby, M.D.
• John Franklin Calvert, D.D.S.
• Julie Ann Carney, LCSW
• Sasha Sherylle Chavez, NP-C
• Sydney Chickrell, RN
• Blair Choate, BSN
• James Cleveland, CRNA

• Surgery Physician in Ketchum, ID
• Providers in Ketchum, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.