Corey R. Campbell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10004224A Issued in IN

Practice address

7900 W Jefferson Blvd Ste 201
Fort Wayne, IN 46804-4128

Phone

(260) 969-7216

Fax

(260) 969-7230

NPI assigned

Jul 22, 2014

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Dupont Hospital LLC Hospital, Fort Wayne, IN, CCN 150150
• Adams Memorial Hospital Hospital, Decatur, IN, CCN 151330
• Marion General Hospital Hospital, Marion, IN, CCN 150011
• Woodlawn Hospital Hospital, Rochester, IN, CCN 151313

Merit-based Incentive Payment System (MIPS)

Final score

90.99 of 100Reported as apm

Quality

77.41

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Lutheran Medical Group LLC

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
  • NPI 1164662805
  Medicare reassignment Care Compare group
• Lutheran Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1710275664
  NPD

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

• Adams County Memorial Hospital

  • Critical Access Hospital
  • Decatur, IN
  • NPI 1689696148
  Care Compare affiliation
• Dupont Hospital LLC

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1538110556
  Care Compare affiliation
• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Marion General Hospital

  • General Acute Care Hospital
  • Gas City, IN
  • NPI 1760186373
  Care Compare affiliation
• Marion General Hospital

  • General Acute Care Hospital
  • Marion, IN
  • NPI 1770679201
  Care Compare affiliation
• Marion General Hospital

  • Nutrition Support Registered Nurse
  • Marion, IN
  • NPI 1861578072

  Hospital

  Care Compare affiliation
• Marion General Hospital

  • Land Ambulance
  • Marion, IN
  • NPI 1932295466

  Hospital

  Care Compare affiliation
• Woodlawn Hospital

  • Critical Access Hospital
  • Rochester, IN
  • NPI 1265413405
  Care Compare affiliation

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1629485677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W JEFFERSON BLVD STE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044128",
            "telephone_number": "260-969-7216",
            "fax_number": "260-969-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "COREY",
        "middle_name": "R.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-22",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004224A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hallie Camos, RBT
• Campbell Community Solution
• Abigail Campbell
• Andrew Campbell
• Brittany Lesha Campbell
• David A Campbell, MD
• David Todd Campbell, LCSW
• Jenna Campbell
• Jennifer Campbell, PHARMD
• Karen M Campbell, LMHC

• Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.
• 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.