Jesse R. Campbell, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20229 Issued in OK

Practice address

1575 N Santa Fe Ave
Edmond, OK 73003-3638

Phone

(405) 285-0660

Fax

(405) 285-0659

NPI assigned

May 9, 2006

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 3

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Oklahoma College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcampbell17135@directc.mercy.net

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Oklahoma Heart Hospital South LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1841442274

  Corporate Director

  CMS ownership
• Oklahoma Heart Hospital, LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1083617005

  Corporate Director

  CMS ownership

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550

  Internal Medicine, OK

  Medicare reassignment Care Compare group NPD
• Mercy Hospital Logan County Inc

  • Critical Access Hospital
  • Guthrie, OK
  • NPI 1306126818

  OK

  Medicare reassignment NPD
• Mercy Clinic Oklahoma Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Oklahoma City, OK
  • NPI 1750986295
  Care Compare group NPD
• Mercy Hospital Logan County, Inc

  • Rural Health Clinic/Center
  • Guthrie, OK
  • NPI 1184905507
  NPD
• Mercy Hospital Logan County, Inc

  • Rural Health Clinic/Center
  • Crescent, OK
  • NPI 1659652071
  NPD
• Integris Ambulatory Care C Orporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1326076027
  NPD (past)
• Mercy Hospital Oklahoma City, Inc

  • Diagnostic Radiology Physician
  • Yukon, OK
  • NPI 1730326406
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1982653721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "SUITE 140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-755-1515",
            "fax_number": "405-936-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N SANTA FE AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033638",
            "telephone_number": "405-285-0660",
            "fax_number": "405-285-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JESSE",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "20229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "20229",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100108140A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBNDD",
            "identifier": "25208",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Campbell Comprehensive Psychological Services, LLC
• Christopher Campbell, PH.D.
• Danielle Nicole Campbell, PH.D.
• Eric J Campbell, PA-C
• Haven Rose Campbell
• Michayla Anne Campbell, SLP
• Can DO Kids Therapy
• Emma Candelaria, RBT
• Candida Barber, LPC PLLC
• Carissa Temple Candler, MD

• All providers in Edmond, OK
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.