Individual provider Active NPI

John H Campbell, M.D.

  • Surgery Physician
  • Gadsden, AL
National Provider Identifier
1992762041
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
3974 Issued in AL
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

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
51545249OtherALBC & BS OF AL
51000960OtherALBC & BS OF AL
510I020002OtherALMEDICARE PTAN
51537150OtherALBC & BS OF AL
000000960MedicaidAL
009912177MedicaidAL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
3974ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Dermatology Group PA CurrentSince Apr 1, 2016 Accepting new patients
The Surgical Clinic of Anniston, PA PastSince Oct 16, 2022 Accepting new patients
Longleaf Primary Care, LLC PastSince Jun 26, 2022 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.

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

Verify at the official NPI Registry.