Patrecia Campbell, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

902559 Issued in MS

Practice address

2570 Bailey Ave Ste 7
Jackson, MS 39213-6905

Phone

(769) 251-1408

NPI assigned

Aug 1, 2020

Sex

Female

Sole proprietor

No

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

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Mississippi Civic Improvement Association, IncGroup PAC ID 4183533235, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Central Mississippi Civic Improvement Association, Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1134151442

  MS

  Medicare reassignment NPD
• Central Mississippi Civic Improvement Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1215744396
  NPD
• Central Mississippi Civic Improvement Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1427377266
  NPD
• Central Mississippi Civic Improvement Association, Inc

  • Federally Qualified Health Center (FQHC)
  • Vicksburg, MS
  • NPI 1932145539
  NPD (past)
• Central Mississippi Civic Improvement Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1154424554
  NPD (past)
• Southeast Mississippi Rural Health Initiative, Inc.

  • Federally Qualified Health Center (FQHC)
  • Petal, MS
  • NPI 1225073968
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1596240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596240000000",
    "number": "1992315212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 LEXINGTON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392096325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 BAILEY AVE STE 7",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392136905",
            "telephone_number": "769-251-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "PATRECIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-01",
        "last_updated": "2020-08-01",
        "certification_date": "2020-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Thomas Campbell, NP-C
• Jeremy Campbell
• Joshua Grice Campbell, MD
• Liana Renee Campbell, M.D.
• Nancy L Campbell, M.D.
• William Francis Campbell, M.D.
• Campkidz Unlimited
• Victoria Canada
• Candid Mississippi, P.C.
• Ashley Miller Canizaro, M.D.

• All providers in Jackson, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.