Active NPI
John H Campbell, M.D.
- Surgery Physician
- Gadsden, AL
National Provider Identifier
1992762041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 3974
- Practice address
- 1007 Goodyear Ave
Gadsden, AL 35903-1195 - Phone
- (256) 413-6480
- Fax
- (256) 413-6493
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 3974 | AL | |
| Surgery Physician | 208600000X | 3974 | AL | Primary |
Addresses
Primary practice location
1007 Goodyear Ave
Gadsden, AL 35903-1195
Mailing address
PO Box 5430
Anniston, AL 36205-0430
Phone (256) 241-2276
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51545249 | Other | AL | BC & BS OF AL |
| 51000960 | Other | AL | BC & BS OF AL |
| 510I020002 | Other | AL | MEDICARE PTAN |
| 51537150 | Other | AL | BC & BS OF AL |
| 000000960 | Medicaid | AL | |
| 009912177 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071029000012 | AL | Practitioner - General Surgery | 1951215342 |
Reassigns benefits to 1 organization Practice locations: Gadsden, AL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3974 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Dermatology Group PA | Current | Accepting new patients | |
| The Surgical Clinic of Anniston, PA | Past | Accepting new patients | |
| Longleaf Primary Care, LLC | Past | Accepting new patients |
Locations
106 Westside Dr
Dothan, AL 36303
Phone (334) 699-3376
101 Cherry St
Gadsden, AL 35901
Phone (256) 543-2380
2505 Harrison Ave
Panama City, FL 32405
Phone 85023333762619
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Anniston, AL
- NPI 1255062832
-
- Specialist
- Anniston, AL
- NPI 1437121050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456099200000",
"number": "1992762041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5430",
"city": "ANNISTON",
"state": "AL",
"postal_code": "362050430",
"telephone_number": "256-241-2276",
"fax_number": "256-238-0555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 GOODYEAR AVE",
"city": "GADSDEN",
"state": "AL",
"postal_code": "359031195",
"telephone_number": "256-413-6480",
"fax_number": "256-413-6493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "JOHN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2016-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "AL",
"license": "3974",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AL",
"license": "3974",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC & BS OF AL",
"identifier": "51545249",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC & BS OF AL",
"identifier": "51000960",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "510I020002",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC & BS OF AL",
"identifier": "51537150",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000000960",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009912177",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gadsden, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.