Individual provider Active NPI

Jennifer Lynn Campbell, D.O.

  • Emergency Medicine Physician
  • Bryn Mawr, PA
National Provider Identifier
1174730501
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS014393 Issued in PA
Practice address
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone
(484) 337-3000
NPI assigned
May 16, 2007
Last updated
Dec 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS010393 PA
Emergency Medicine Physician 207P00000X OS014393 PA Primary

Addresses

Primary practice location

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

Mailing address

PO Box 8500-8735
Philadelphia, PA 19178-0001
Phone (215) 456-7000

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-6679

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000101 PA Practitioner - Emergency Medicine 1052489614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

154 Exton Square Mall
Exton, PA 19341-2440
Phone (484) 565-8500

1991 Sproul Rd
Suite 600
Broomall, PA 19008-3517
Phone (484) 421-1669

450 Cresson Blvd
Phoenixville, PA 19460-6145

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS010393PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Dec 28, 2018 Accepting new patients
Trinity Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Trinity Emergency Physicians, LLC Emergency Medicine PastSince Feb 9, 2020 Accepting new patients
Einstein Practice Plan Inc PastSince Jul 1, 2008 Accepting new patients

Locations

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1174730501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500-8735",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780001",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-6679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS010393",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS014393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.