Mrs Theresa Ann Campbell, APRN,BC,FNP is a medicare enrolled "Nurse Practitioner - Family" in Slater, Missouri. Her current practice location is
420 West Front Street, Slater, Missouri. You can reach out to her office (for appointments etc.) via phone at
(660) 529-2251.
Mrs Theresa Ann Campbell is licensed to practice in Missouri (license number 069859) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1629102025.
Provider's Profile
| Full Name | Mrs Theresa Ann Campbell |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 420 West Front Street, Slater, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1629102025
- Provider Enumeration Date: 03/15/2007
- Last Update Date: 08/25/2021
Medicare PECOS Information:
- PECOS PAC ID: 6608065776
- Enrollment ID: I20110105001206
Medical Identifiers
Medical identifiers for Mrs Theresa Ann Campbell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629102025 | NPI | - | NPPES |
| 1629102025 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | RN069859 (Missouri) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 069859 (Missouri) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Theresa Ann Campbell allows following entities to bill medicare on her behalf.
| Entity Name | John Fitzgibbon Memorial Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285650176
PECOS PAC ID: 2567351570
Enrollment ID: O20080708000234 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Theresa Ann Campbell is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Theresa Ann Campbell, APRN,BC,FNP
420 West Front Street,
Slater, MO 65349-1328
Ph: (660) 529-2251 | Mrs Theresa Ann Campbell, APRN,BC,FNP
420 West Front Street,
Slater, MO 65349-1328
Ph: (660) 529-2251 |
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