NPIMap

Individual provider Active NPI

Jeremy Campbell, DO

  • Family Medicine Physician
  • Newark, OH
National Provider Identifier
1477533826
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34007871 Issued in OH
Practice address
1930 Tamarack Rd
Newark, OH 43055-2303
Phone
(740) 522-7600
Fax
(740) 522-6399
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34007871 OH Primary

Addresses

Primary practice location

1930 Tamarack Rd
Newark, OH 43055-2303

Mailing address

1930 Tamarack Rd
Newark, OH 43055-2303
Phone (740) 522-7600

Other identifiers 1

IdentifierTypeStateIssuer
2488544MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040831001555 OH Practitioner - Family Practice 3779558812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical and Surgical Associates IncGroup PAC ID 5890760938, 9 clinicians

Practice addresses (Care Compare)

1930 Tamarack Rd
Newark, OH 43055-2303
Phone (740) 522-7600

Hospital & facility affiliations

  • Premier Home Health LLC Home health agency, Newark, OH, CCN 369198
  • Centerwell Home Health II Home health agency, Mount Vernon, OH, CCN 368015
  • Hospice of Central Ohio Hospice, Newark, OH, CCN 361525
  • Bella Care Hospice Hospice, Westerville, OH, CCN 361646
  • Ohio Living Hospice Greater Columbus Hospice, Westerville, OH, CCN 361632
  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
  • Flint Ridge NRSG & Rehab Ctr Nursing home, Newark, OH, CCN 365485
  • Arlington Care Center Nursing home, Newark, OH, CCN 365440

Merit-based Incentive Payment System (MIPS)

Final score
89.61 of 100Reported as group
Quality
97.53
Improvement activities
40
Cost
68.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical and Surgical Associates Inc Family Medicine CurrentSince Jul 12, 2004 Accepting new patients
CHS - Arlington, Inc Past Accepting new patients
Flint Ridge Healthcare LLC Past Accepting new patients

Locations

1930 Tamarack Rd
Newark, OH 43055
Phone (740) 344-6901

Interoperability endpoints

  • Direct secure messaging: jeremycampbell@masai-oh.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arlington Care CenterNewark, OH, CCN 365440 Skilled nursing facility Adp of the SNF Jan 1, 2011
Generation Hospice LLCNewark, OH, CCN 361645 Hospice Contracted Managing Employee Sep 30, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1477533826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-522-7600",
            "fax_number": "740-522-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-522-7600",
            "fax_number": "740-522-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34007871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2488544",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.