Lisa Lynne Butenhoff Campbell, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

50518-20 Issued in WI

Practice address

1400 Scheuring Rd
De Pere, WI 54115-1067

Phone

(920) 964-0229

Fax

(920) 686-9674

NPI assigned

Mar 24, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 5

Electronic endpoints 12

Medicare fee-for-service enrollment

Enrolled in WI, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

University of Wisconsin School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, shared by 26 NPIs, 650 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.campbell@forefrontdermatology.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Appleton, WI
  • NPI 1083768253
  Medicare reassignment NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Grand Rapids, MI
  • NPI 1912347923
  Medicare reassignment NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Shawano, WI
  • NPI 1508155474
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Marquette, MI
  • NPI 1891125290
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1124145040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SCHEURING RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541151067",
            "telephone_number": "920-964-0229",
            "fax_number": "920-686-9674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 Maxwell Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540164004",
            "country_code": "US",
            "telephone_number": "715-386-5278",
            "fax_number": "715-386-5508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Superior Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543117595",
            "country_code": "US",
            "telephone_number": "920-406-9803",
            "fax_number": "920-406-9934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3500 Ludington St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Escanaba",
            "state": "MI",
            "postal_code": "498294218",
            "country_code": "US",
            "telephone_number": "906-553-6093",
            "fax_number": "906-553-6958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Hancock",
            "state": "MI",
            "postal_code": "499301452",
            "country_code": "US",
            "telephone_number": "906-523-2223",
            "fax_number": "906-523-2227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1007 Harbor Hills Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498558977",
            "country_code": "US",
            "telephone_number": "906-225-5458",
            "fax_number": "906-225-1179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2806 Riverview Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543136717",
            "country_code": "US",
            "telephone_number": "920-498-7546",
            "fax_number": "920-569-4129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3515 Murray St",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433367",
            "country_code": "US",
            "telephone_number": "715-732-0699",
            "fax_number": "715-732-3522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3935 N Lightning Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549136717",
            "country_code": "US",
            "telephone_number": "920-968-1790",
            "fax_number": "920-968-1794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501A Vern Holmes Dr",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544829791",
            "country_code": "US",
            "telephone_number": "715-344-0172",
            "fax_number": "715-344-3684",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 N 17th Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544014281",
            "country_code": "US",
            "telephone_number": "715-849-5333",
            "fax_number": "715-849-4083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2351 State Road 44",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549046333",
            "country_code": "US",
            "telephone_number": "920-651-8855",
            "fax_number": "920-385-0287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "LISA",
        "middle_name": "LYNNE BUTENHOFF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-24",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD430734",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MI",
            "license": "4301105435",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "50518-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "50518-020",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "171400016",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124145040",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00720349",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "382000020",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "3515 Murray St",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541433367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "5501A Vern Holmes Dr",
            "city": "Stevens Point",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544829791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "510 N 17th Ave Ste C",
            "city": "Wausau",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544014281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1400 Scheuring Rd",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541151067",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "715 Superior Rd Ste 120",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543117595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "3500 Ludington St Ste 300",
            "city": "Escanaba",
            "state": "MI",
            "country_code": "US",
            "postal_code": "498294218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "500 Campus Dr",
            "city": "Hancock",
            "state": "MI",
            "country_code": "US",
            "postal_code": "499301452",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1007 Harbor Hills Dr Ste C",
            "city": "Marquette",
            "state": "MI",
            "country_code": "US",
            "postal_code": "498558977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "3935 N Lightning Dr",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549136717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2806 Riverview Dr",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543136717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1610 Maxwell Dr Ste 210",
            "city": "Hudson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540164004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Campbell@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2351 State Road 44",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549046333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Karen M Camilli, MD
• Amanda R Cardinal, LPC
• Care Companions, LLC
• Charis N Carter, DPT
• Charles Carter, LPC
• Danielle Casper, LMFT, CSAC

• Dermatology Physician in De Pere, WI
• Providers in De Pere, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.

Verify at the official NPI Registry.