Henry Martin-del-Campo

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-062779 Issued in IL

Practice address

435 Maxine Dr
Morton, IL 61550-2498

Phone

(309) 263-2424

Fax

(309) 284-2255

NPI assigned

Oct 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD
• Methodist Medical Center of Illinois

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  NPD

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1457441743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 MAXINE DR",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502498",
            "telephone_number": "309-263-2424",
            "fax_number": "309-284-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 MAXINE DR",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502498",
            "telephone_number": "309-263-2424",
            "fax_number": "309-284-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-DEL-CAMPO",
        "first_name": "HENRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-062779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00622434",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP #",
            "identifier": "CA2182",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360562779",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP # FOR PONTIAC",
            "identifier": "833230",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald Luce
• Laura Lee Luginbuhl, SLP
• Heather Maciver Arnold
• Marshall Internal Medicine, S.C.
• Douglas J Marshall, M.D.
• Anne Elizabeth Mayo
• Abbi McGinty, LCSW
• Jennifer L McNulty, LPTA
• Katherine Merila
• Ron Messner, MSW

• Family Medicine Physician in Morton, IL
• Providers in Morton, IL by specialty
• Family Medicine Physician in Illinois

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

Verify at the official NPI Registry.