MARC T CAMPOS (NPI# 1336589241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336589241 |
| Entity Type | Individual |
| Full Name | MARC T CAMPOS |
| Credential | PA-C |
| Practice Address |
1103 N Baldwin Avenue Marion IN 46952-2536 |
| Mailing Address |
330 N Wabash G20 Marion IN 46952-2600 |
| Practice Telephone | 7656607480 |
| Practice Fax Number | 7653824495 |
| Mailing Telephone | 7656607600 |
| Mailing Fax Number | 7656517313 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2019-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | IN | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
4367 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 00001216651 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12 Lathrop Rd, Plainfield, CT 063742061 | 8604579191 | |
| 326 Washington St, Norwich, CT 063602740 | 8608898331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487715785 | Marc Anthony Campos | Social Worker | 2101 Courage Dr, Fairfield, CA 94533-6717 | 2006-12-12 |
| Street Address |
1103 N BALDWIN AVENUE |
| City | MARION |
| State | IN |
| Zip Code | 46952-2536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487995858 | Melissa Ann Wood-heller | Nurse Practitioner | 1103 N Baldwin Avenue, Marion, IN 46952-2600 | 2013-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982245874 | John Robert Searfoss Sr. | Counselor | 314 S Norton Ave., Marion, IN 46952 | 2019-10-02 |
| 1063069755 | Andrea Marie Brown | Behavior Technician | 2315 W 2nd St, Marion, IN 46952 | 2019-08-19 |
| 1548767767 | Johnnie Micheal Hiles | Counselor | 315 South Norton Ave., Marion, IN 46952 | 2018-04-13 |
| 1669979936 | Sheila Ann Johnson | Counselor | 315 S. Norton Ave, Marion, IN 46952 | 2018-04-12 |
| 1679070957 | Marissa Lynn Castillo | Counselor | 315 S Norton Avenue, Marion, IN 46952 | 2018-04-12 |
| 1326545609 | Eumalla Lampkins | Case Manager/Care Coordinator | 315 South Norton Avenue, Marion, IN 46952 | 2018-04-12 |
| 1285011650 | Forefront Dermatology, S.c. | Dermatology | 330 N Wabash Ave Ste 360, Marion, IN 46952 | 2015-05-05 |
| 1649510959 | Cancer Services of Grant County Inc. | Prosthetic/Orthotic Supplier | 305 S. Norton Ave., Marion, IN 46952 | 2013-02-22 |
| 1326350844 | Beth Ellen Krouse | Speech-Language Pathologist | 1800 Wabash Ave, Suite 200, Marion, IN 46952 | 2010-07-13 |
| 1093032138 | Thomas Alfred Beck | General Practice | 919 Euclid Avenue, Marion, IN 46952 | 2010-04-29 |
| Find all providers in zip 46952 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285704585 | Keith Charles Damico | Physician Assistant | 5235 Nc 226 S, Marion, NC 28752-8733 | 2006-11-08 |
| 1578178679 | Amelia Kate Stigall | Physician Assistant | 1301 E Deyoung St, Marion, IL 62959-3846 | 2020-09-15 |
| 1689223208 | Emily Jane Bodfish | Physician Assistant | 1204 N Main St, Marion, VA 24354-4312 | 2019-09-06 |
| 1306343512 | Cody Jordan Harris | Physician Assistant | 970 S Prospect St, Marion, OH 43302-6225 | 2018-04-12 |
| 1174989800 | Andrew Michael Bandsuh | Physician Assistant | 1000 Mckinley Park Dr, Marion, OH 43302-6399 | 2016-01-11 |
| 1295108363 | Julia Petraitis | Physician Assistant | 1728 Marion Waldo Rd, Marion, OH 43302-7457 | 2015-11-11 |
| 1396146460 | Cameron M Ratcliff | Physician Assistant | 1616 N Main St, Ste 100a, Marion, VA 24354-4473 | 2014-09-09 |
| 1447593694 | Harry William Howe | Physician Assistant | 1583 N Main St, Marion, VA 24354-4317 | 2013-04-05 |
| 1295088748 | Zed Alex Mansfield | Physician Assistant | 2293 Sugar Hill Rd Ste D, Marion, NC 28752-7787 | 2012-10-22 |
| 1003079328 | Karen Pauley | Physician Assistant | 402 S State St, Marion, OH 43302-5000 | 2008-07-07 |
| Find all providers in MARION | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.