AUTUMN CAMPBELL (NPI# 1396110656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396110656 |
| Entity Type | Individual |
| Full Name | AUTUMN CAMPBELL |
| Credential | PA-C |
| Practice Address |
4634 Hills and Dales Rd Nw Canton OH 44708-1510 |
| Practice Telephone | 3304770255 |
| Practice Fax Number | 3304790392 |
| Mailing Telephone | 3304770255 |
| Mailing Fax Number | 3304790392 |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2015-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 004534 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619275872 | Autumn Brooke Campbell | Specialist/Technologist | 5316 Trail Lake Dr, Fort Worth, TX 76133-1931 | 2011-03-11 |
| Street Address |
4634 HILLS AND DALES RD NW |
| City | CANTON |
| State | OH |
| Zip Code | 44708-1510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093793994 | Irina Korableva | Internal Medicine | 4634 Hills and Dales Rd Nw, Canton, OH 44708-1510 | 2006-01-03 |
| 1558751453 | Melissa J Thomas | Nurse Practitioner | 4634 Hills and Dales Rd Nw, Canton, OH 44708-1510 | 2015-01-29 |
| 1497056428 | Cassandra E Porter | Nurse Practitioner | 4634 Hills and Dales Rd Nw, Canton, OH 44708-1510 | 2010-11-08 |
| 1538263215 | Suzanne Michelle Harold | Internal Medicine | 4634 Hills and Dales Rd Nw, Canton, OH 44708-1510 | 2006-09-12 |
| 1255434494 | Northeast Ohio Endocrinology | Internal Medicine | 4634 Hills and Dales Rd Nw, Canton, OH 44708-1510 | 2006-09-06 |
| 1275635153 | Kathryn Sue Fritz | Nurse Practitioner | 4634 Hills and Dales Rd Nw, Canton, OH 44708-1510 | 2006-09-02 |
| 1528027810 | Lori M Christopher | Nurse Practitioner | 4634 Hills and Dales Rd Nw, Canton, OH 44708-1510 | 2006-03-23 |
| 1669450557 | Kevin Gerard Wietecha | Internal Medicine | 4634 Hills and Dales Rd Nw, Canton, OH 44708-1510 | 2006-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669072583 | Xl Developmental Services, Inc. | Home Health | 4403 19th St Nw, Canton, OH 44708 | 2020-10-29 |
| 1942827084 | Emily Glor | Dentist | 1320 Mercy Drive Northwest, Attn: Dental Services, Canton, OH 44708 | 2020-07-05 |
| 1811479009 | Linda Adams | Counselor | 2421 13th Street Nw, Canton, OH 44708 | 2018-09-04 |
| 1104308527 | Toreka Lishay Miller | Social Worker | 2421 13th Nw, Canton, OH 44708 | 2018-09-01 |
| 1679051213 | Edward Arthur Hill | Family Medicine | 6104 Cedar Lane Nw, Canton, OH 44708 | 2018-08-06 |
| 1467939371 | Kristen M Reardon | Registered Nurse | 1330 Mercy Dr Nw Ste 319, Canton, OH 44708 | 2018-07-24 |
| 1538659131 | Jeffrey Scott Mechtenberg | Chiropractor | 3410 Tuscarawas Street W, Canton, OH 44708 | 2018-05-18 |
| 1699284844 | Our Caring Hands Home Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3005 W. Tuscuswas St, Canton, OH 44708 | 2017-09-20 |
| 1528580933 | Elizabeth Ann Bonchek | Licensed Practical Nurse | 4550 Hills and Dales Nw Road, Canton, OH 44708 | 2017-07-07 |
| 1518315837 | Bio-medical Applications of Ohio, Inc. | Clinic/Center | 2835 Tuscarawas St. West, Canton, OH 44708 | 2016-05-26 |
| Find all providers in zip 44708 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164048674 | Rebecca Lynn Yunk | Physician Assistant | 50433 Monroe St, Canton, MI 48188-6601 | 2020-06-20 |
| 1780210781 | Olivia Anastasia Basso | Physician Assistant | 4912 Higbee Ave Nw Ste 200, Canton, OH 44718-2599 | 2020-03-21 |
| 1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
| 1578113593 | Luiza Lica | Physician Assistant | 246 Princess Dr, Canton, MI 48188-1142 | 2019-09-12 |
| 1235614900 | Eva Louisa Paoloni | Physician Assistant | 1105 W Maple St Apt 3, Canton, OH 44720-2869 | 2018-09-28 |
| 1992281653 | Elizabeth Judy | Physician Assistant | 460 Northside Cherokee Blvd Ste 430, Canton, GA 30115-8020 | 2018-07-16 |
| 1083124051 | Stephanie Black | Physician Assistant | 1455 Harrison Ave Nw Ste 105, Canton, OH 44708-2609 | 2017-10-04 |
| 1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
| 1588111074 | Kinjal Shah | Physician Assistant | 43767 Ford Rd, Canton, MI 48187-3185 | 2016-09-01 |
| 1144683731 | Ellen Catherine Mitchell | Physician Assistant | 48575 Joy Rd, Canton, MI 48187-1214 | 2016-03-31 |
| Find all providers in CANTON | ||||
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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.