Katie M Campbell, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G124568 Issued in IA

Practice address

1690 Elm St Ste 300
Dubuque, IA 52001-3679

Phone

(563) 690-2850

Fax

(635) 557-8488

NPI assigned

Jun 30, 2010

Last updated

Aug 10, 2023By the provider in NPPES

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 names 1

• Katie M Hanson Former name

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Crescent Community Health CenterGroup PAC ID 0345343158, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcampbell637346@direct.ochin.org

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.

• Crescent Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Dubuque, IA
  • NPI 1720146319
  Medicare reassignment Care Compare group NPD
• Katie Marie Campbell Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Dubuque, IA
  • NPI 1528662046
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1275844649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 ELM ST STE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013679",
            "telephone_number": "563-690-2850",
            "fax_number": "635-557-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 ELM ST STE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013679",
            "telephone_number": "563-690-2850",
            "fax_number": "635-557-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KATIE",
        "middle_name": "M",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "IA",
            "license": "G124568",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "124568",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G124568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "HANSON",
            "middle_name": "M",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bailey Louise Callahan, MA
• Janet Catherine Callahan, LISW
• John Michael Callahan, M.D.
• Thomas Eldon Callahan, D.O.
• Kristen Louise Calvert, M.S. CCC-SLP
• Zhengjin Cao, M.D.
• Rhonda A Carbone, BC/HIS
• Care for You LLC
• Care Initiatives (Dubuque Specialty Care)
• Cynthia Carr, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.