CAMPBELL MEDICAL GROUP (CAMPBELL MEDICAL GROUP, MD, PSC) NPI 1003000803
Family Medicine in Glasgow, KY
About CAMPBELL MEDICAL GROUP (CAMPBELL MEDICAL GROUP, MD, PSC)
Campbell Medical Group (campbell Medical Group, Md, Psc) is a provider established in Glasgow, Kentucky specializing in family medicine. The NPI number of Campbell Medical Group (campbell Medical Group, Md, Psc) is 1003000803 and was assigned on September 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 33935 (KY). The provider is registered as an organization and their NPI record was last updated 12 years ago. Campbell Medical Group (campbell Medical Group, Md, Psc) operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's other name is Campbell Medical Group. The authorized official of this NPI record is Ms. Jennifer Dalton Gibson Rhit (Office Manager)
| NPI | 1003000803 |
| Provider Name | CAMPBELL MEDICAL GROUP (CAMPBELL MEDICAL GROUP, MD, PSC) |
| Provider Location Address | 303 PROFESSIONAL PARK DR GLASGOW, KY 42141 |
| Provider Mailing Address | 303 PROFESSIONAL PARK DR GLASGOW, KY 42141 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Other Organization Name | CAMPBELL MEDICAL GROUP |
| Other Name Type | Other Name (5) |
| Enumeration Date | 09-05-2007 |
| Last Update Date | 12-05-2007 |
Primary Taxonomy
| Taxonomy Code | 207Q00000X |
| Classification | Family Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 33935 |
| License State | KY |
| Taxonomy Description | Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Business Address
CAMPBELL MEDICAL GROUP
303 PROFESSIONAL PARK DR
GLASGOW, KY
ZIP 42141
Phone: (270) 629-3772
Fax: (270) 629-3774
Mailing Address
CAMPBELL MEDICAL GROUP
303 PROFESSIONAL PARK DR
GLASGOW, KY
ZIP 42141
Phone: (270) 629-3772
Fax: (270) 629-3774
Group Taxonomy
193400000X MULTIPLE SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 207RA0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine | 34221 | KY | No |
Taxonomy Description: an internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. | |||||||
| 2 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 4716P | KY | No | |
Taxonomy Description: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| 000000360876 | OTHER (01) | KY |
| 0922102 | MEDICARE UPIN (02) | KY |
| 64019003 | MEDICAID (05) | KY |
| 9221 | MEDICARE PIN (08) | KY |
| 0922101 | MEDICARE UPIN (02) | KY |
| 000000333249 | OTHER (01) | KY |
| 64095326 | MEDICAID (05) | KY |
Other Providers at the same location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1811473218 | CUMBERLAND FAMILY MEDICAL CENTER, INC. Organization | Clinic/Center (Federally Qualified Health Center (FQHC)) | 303 PROFESSIONAL PARK DR GLASGOW, KY 42141 (270) 651-9696 |
| 1952546020 | PSYCHIATRIC WELLNESS ASSOCIATES Organization | Nurse Practitioner (Psychiatric/Mental Health) | 303 PROFESSIONAL PARK DR GLASGOW, KY 42141 (270) 629-2120 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.