JEREMIAH JAYMES CAMPBELL (PT, DPT) – Physical Therapist, NPI 1164082582

JEREMIAH JAYMES CAMPBELL (PT, DPT) is a healthcare provider. based in Shoreline, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. PT60933679 (WA). The NPI Number for JEREMIAH JAYMES CAMPBELL (PT, DPT) is 1164082582

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
JEREMIAH JAYMES CAMPBELL (PT, DPT)
NPI
1164082582
Phone
(425) 350-0133
Address
19241 ASHWORTH AVE N
Enumeration Date
18 June 2019
Last Update Date
26 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5097544631
Graduation Year
2019 (7 years ago)
PAC ID
7911340641
Group Practice PAC ID
6709775166
Professional Enrollment ID
I20240208004180
Address ID
WA988231997EP200XXWAYX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

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Provider Addresses for JEREMIAH JAYMES CAMPBELL (PT, DPT)

  • 19241, Ashworth Avenue North, Meridian Park, Echo Lake, Shoreline, King County, Washington, 98133, United States

    SHORELINE, WA 981333618

    Phone: (425) 350-0133

    Type: Mailing

  • 200 NAT WASHINGTON WAY

    EPHRATA, WA 988231982

    Phone: (509) 717-5214

    Type: Mailing

  • Columbia Basin Hospital, 200, Nat Washington Way, Ephrata, Grant County, Washington, 98823, United States

    EPHRATA, WA 988231997

    Phone: (509) 754-4631

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240208004180IPhysical Therapist In Private PracticeWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98133)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709775166View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeOR
Cardiovascular Disease (Cardiology)WA
Physician AssistantWA
Diagnostic RadiologyWA
Physical Therapist In Private PracticeWA
Qualified Speech Language PathologistOK
Occupational Therapist In Private PracticeCA
Physician AssistantFL
Diagnostic RadiologyWA
Emergency Medicine, Family PracticeWA

Reviews

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Frequently asked questions

What is JEREMIAH JAYMES CAMPBELL (PT, DPT)'s NPI number?
JEREMIAH JAYMES CAMPBELL (PT, DPT)'s NPI is 1164082582 — the number used across U.S. healthcare to identify this provider.
Would JEREMIAH JAYMES CAMPBELL (PT, DPT) appear as active to a payer?
You can treat JEREMIAH JAYMES CAMPBELL (PT, DPT) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to JEREMIAH JAYMES CAMPBELL (PT, DPT)?
JEREMIAH JAYMES CAMPBELL (PT, DPT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
Is JEREMIAH JAYMES CAMPBELL (PT, DPT) located near Shoreline?
JEREMIAH JAYMES CAMPBELL (PT, DPT) currently maps to Shoreline, Washington in this extract.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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