Robert Ian Campbell Jr.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

09859 Issued in IA

Practice address

1116 Pennsylvania Ave
Ottumwa, IA 52501-2109

Phone

(641) 682-2350

NPI assigned

Apr 22, 2015

Last updated

Apr 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• R. Ian Campbell D.D.S, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Ottumwa, IA
  • NPI 1861066029
  NPD Authorized official
• Gregory P. Vannucci D.D.S.,P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Ottumwa, IA
  • NPI 1790969459
  NPD (past)

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1376930867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1369 SPRUCE PL APT 1005",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032692",
            "telephone_number": "870-816-5691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012109",
            "telephone_number": "641-682-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ROBERT",
        "middle_name": "IAN",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-22",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": "09859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Lynn Brownlee, COTA/LCT
• David Ira Bunce, RPH.
• Susan Burgdorf, CADC
• David Lee Burrows, ARNP
• Kimberly Sue Burton, RPH, PHARM D
• Bethany Canny, CADC
• Jonathan Ellsworth Cardon, RN
• Care Initiatives (Ridgewood Specialty Care)
• Carlenrose Corporation (Carlenrose Logistics, Ottumwa Cab)
• Tiffany Jo Carriker, HEARING SPECIALIST

• Oral and Maxillofacial Surgery (Dentist) in Ottumwa, IA
• Providers in Ottumwa, IA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.