Physician Compare National (NPI:1780054452)

HEALTHCARE PROVIDER: MELODYE GAIL CAMPBELL APRN

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1780054452
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507169505
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160126000838
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CAMPBELL
	Individual professional last name
Provider First Name	MELODYE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2015
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	GREENVIEW PRIMECARE LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9436240207
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	13
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1325 ANDREA ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	BOWLING GREEN
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	421045853
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2709013454
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	180124
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GREENVIEW REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	180013
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	THE MEDICAL CENTER (BOWLING GREEN)
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y