Basic Information
Provider Information
NPI: 1508259946
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAMPBELL
FirstName: REBEKAH
MiddleName: JILLIAN
NamePrefix: DR.
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 600 JULIAN LN STE 660
Address2:  
City: ARDEN
State: NC
PostalCode: 287047815
CountryCode: US
TelephoneNumber: 8286843611
FaxNumber: 8286843612
Practice Location
Address1: 600 JULIAN LN STE 660
Address2:  
City: ARDEN
State: NC
PostalCode: 287047815
CountryCode: US
TelephoneNumber: 8286843611
FaxNumber: 8286843611
Other Information
ProviderEnumerationDate: 03/10/2015
LastUpdateDate: 08/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XP20742NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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