Provider Demographics
NPI:1164427035
Name:CAMPITELLI, NICHOLAS A (DPM)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:A
Last Name:CAMPITELLI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 W MARKET ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4208
Mailing Address - Country:US
Mailing Address - Phone:330-926-3231
Mailing Address - Fax:330-255-5080
Practice Address - Street 1:2660 W MARKET ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4208
Practice Address - Country:US
Practice Address - Phone:330-926-3231
Practice Address - Fax:330-255-5080
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003366213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2511795Medicaid
OH300506709027OtherCARESOURCE
OH000000265637OtherUNISON HEALTH PLAN OF OHIO MA
OH593456OtherANTHEM BLUE CROSS BLUE SHIELD
OH2511795Medicaid
OHP00733045OtherRAILROAD MEDICARE
OH4184219OtherCIGNA
OH30-0506709OtherUNITED HEALTHCARE
OH9008992OtherSUMMA
OH7572633OtherAETNA HEALTH PLAN
OH1952056OtherFIRST HEALTH NETWORK/COVENTRY HEALTH CARE NATIONAL NETWORK
OH1952056OtherFIRST HEALTH NETWORK/COVENTRY HEALTH CARE NATIONAL NETWORK
OHP00733045OtherRAILROAD MEDICARE
OH1952056OtherFIRST HEALTH NETWORK/COVENTRY HEALTH CARE NATIONAL NETWORK
U99883Medicare UPIN
OH30-0506709OtherHOMETOWN (HEALTH PLAN OF UPPER OHIO)
OH30-0506709OtherUNITED HEALTHCARE
OH$$$$$$$$$007OtherMEDICAL MUTUAL OF OHIO (FAIRLAWN)
OH9008992OtherSUMMA
OH30-0506709OtherHOMETOWN (HEALTH PLAN OF UPPER OHIO)
OH1952056OtherFIRST HEALTH NETWORK/COVENTRY HEALTH CARE NATIONAL NETWORK
U99883Medicare UPIN
PA4235190001Medicare NSC
OH$$$$$$$$$008OtherMEDICAL MUTUAL OF OHIO (STREETSBORO)
PAU99883OtherHEALTH AMERICA
PA702411OtherUPMC HEALTH PLAN
OH593456OtherANTHEM BLUE CROSS BLUE SHIELD
OHCA4224042Medicare PIN