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KATRINA ANN CAMPBELL
NPI 1760377717
Student in an Organized Health Care Education/Training Program in Coeur D Alene, ID

Active since June 10, 2025PECOS Enrolled
1400 E SHERMAN AVE, COEUR D ALENE, ID 83814(208) 966-4206(208) 966-4220 Get Directions Write a Review

NPPES record last updated: June 10, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Katrina Ann Campbell NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATRINA ANN CAMPBELL (NPI 1760377717) is an individual student in an organized health care education/training program in Coeur D Alene, Idaho and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS, maintains a secondary practice location in Coeur D Alene, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1760377717
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKATRINA ANN CAMPBELL
Location Address1400 E SHERMAN AVECoeur D Alene, ID 83814-4044
Mailing Address1400 E Sherman AveCoeur D Alene, ID 83814-4044 · (208) 966-4206 · Fax (208) 966-4220
Phone(208) 966-4206
Fax(208) 966-4220
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJune 10, 2025
NPPES CertifiedJune 10, 2025
✔ NPI 1760377717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1400 E SHERMAN AVE, Coeur D Alene, ID 83814
Open in Google Maps ↗

Secondary Practice Location 1

Location 11765 W Golf Course RdCoeur D Alene, ID 83815-9033 · Phone (208) 763-0606

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katrina Ann Campbell is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6507345030
PECOS Enrollment IDI20260205001441
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Katrina Campbell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mind Matters LLC
2.3 mi
Multi-Specialty
1875 N LAKEWOOD DR STE 101
Coeur D Alene, ID 83814
  • Reassigned Medicare billing, Idaho enrollment
  • 8 clinicians in this Medicare group
NPI 1376160820 (208) 719-9110

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHRISTOPHER D LAVIOLA PSYD
Psychologist
1400 E SHERMAN AVE
COEUR D ALENE, ID 83814
Kootenai County (208) 966-4206
ALYSSA NICOLE FREITAS MSW
Social Worker
1400 E SHERMAN AVE
COEUR D ALENE, ID 83814
Kootenai County (208) 966-4206
SHIANA MICHELLE FOWLER LMSW
Social Worker
1400 E SHERMAN AVE
COEUR D ALENE, ID 83814
Kootenai County (208) 966-4206
LAVIOLA PSYCHOLOGICAL SERVICES INC
Psychologist
1400 E SHERMAN AVE
COEUR D ALENE, ID 83814
Kootenai County (208) 966-4206
ERIC KLOBETANZ
Counselor (Mental Health)
1400 E SHERMAN AVE
COEUR D ALENE, ID 83814
Kootenai County (208) 966-4206
JACKSON G ROLTGEN
Behavior Technician
1400 E SHERMAN AVE
COEUR D ALENE, ID 83814
Kootenai County (208) 551-2970
PAMELA WHEELER
Case Manager/Care Coordinator
1400 E SHERMAN AVE
COEUR D ALENE, ID 83814
Kootenai County (208) 966-4206
ANDREA FOWLER
Behavior Technician
1400 E SHERMAN AVE
COEUR D ALENE, ID 83814
Kootenai County (208) 551-2970

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katrina Campbell's NPI number?

The NPI number for Katrina Campbell is 1760377717. It was assigned to this individual provider in the NPPES registry on June 10, 2025.

Where is Katrina Campbell located?

Katrina Campbell practices at 1400 E Sherman Ave, Coeur D Alene, ID 83814. The listed phone number is (208) 966-4206.

What is Katrina Campbell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Katrina Campbell enrolled in Medicare?

Yes. Katrina Campbell is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Katrina Campbell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katrina Campbell reassigns Medicare benefits to Mind Matters LLC (Coeur D Alene, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Katrina Campbell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Katrina Campbell accept?

Health plans from Molina Healthcare, PacificSource Health Plans, Providence Health Plan and Select Health list Katrina Campbell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Katrina Campbell was last updated on June 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.