Active NPI
Dwin E Campbell, D.O.
- Internal Medicine Physician
- Dallas, PA
National Provider Identifier
1053305383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- OS-009630-L
- Practice address
- 221 Idetown Rd
Dallas, PA 18612-1136 - Phone
- (570) 674-2998
- Fax
- (570) 639-2559
- NPI assigned
- Sep 1, 2005
- Last updated
- Apr 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | OS-009630-L | PA | |
| Internal Medicine Physician | 207R00000X | OS-009630-L | PA | Primary |
Addresses
Primary practice location
221 Idetown Rd
Dallas, PA 18612-1136
Mailing address
221 Idetown Rd
Dallas, PA 18612-1136
Phone (570) 674-2998
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061220000445 | PA | Practitioner - Internal Medicine | 8325047376 | Practice locations: Dallas, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Philadelphia College of Osteopathic Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
221 Idetown Rd
Dallas, PA 18612-2701
Phone (570) 639-2557
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS-009630-L | PA | MD | Internal Medicine Physician |
Hospital & facility affiliations 22
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Geisinger Pittston Radiology, a Service of GWV
- Diagnostic Radiology Physician
- Pittston, PA
- NPI 1104292960
Hospital
-
- General Acute Care Hospital
- Wilkes Barre, PA
- NPI 1174822068
-
- General Acute Care Hospital
- Wilkes Barre, PA
- NPI 1275620585
-
dba Geisinger HealthPlex CenterPoint
- General Acute Care Hospital
- Pittston, PA
- NPI 1316692585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209340800000",
"number": "1053305383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 IDETOWN RD",
"city": "DALLAS",
"state": "PA",
"postal_code": "186121136",
"telephone_number": "570-674-2998",
"fax_number": "570-639-2559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 IDETOWN RD",
"city": "DALLAS",
"state": "PA",
"postal_code": "186121136",
"telephone_number": "570-674-2998",
"fax_number": "570-639-2559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "DWIN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-01",
"last_updated": "2008-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PA",
"license": "OS-009630-L",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "OS-009630-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.