Individual provider Active NPI

Dawn Campbell, M.S.N./F.N.P.

  • Family Nurse Practitioner
  • Plymouth, IN
National Provider Identifier
1629514799
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28123044A Issued in IN
Practice address
2349 Lake Ave Ste 100
Plymouth, IN 46563-7836
Phone
(574) 948-5100
NPI assigned
Jan 13, 2017
Last updated
May 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28123044A IN Primary

Addresses

Primary practice location

2349 Lake Ave Ste 100
Plymouth, IN 46563-7836

Mailing address

1987 3B Rd
Bremen, IN 46506-9779
Phone (574) 209-0014

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dawn.campbell@directsjpn.mhin.net Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170425000649 IN Practitioner - Nurse Practitioner 0446536619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2349 Lake Ave
Suite 100
Plymouth, IN 46563-7836
Phone (574) 948-5100

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469

60101 Bodnar Blvd
Suite 100B
Mishawaka, IN 46544-9340
Phone (574) 335-8800

611 E Douglas Rd
Mishawaka, IN 46545-1467

611 E Douglas Rd
309 Infectious Diseases
Mishawaka, IN 46545-1469
Phone (574) 335-6770

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28123044AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center, Inc. Current Accepting new patients

Locations

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

60101 Bodnar Blvd
Ste 100B
Mishawaka, IN 46544
Phone (574) 335-8500

611 E Douglas Rd
Ste 309
Mishawaka, IN 46545
Phone (574) 335-6232

2349 Lake Ave
Ste 100
Plymouth, IN 46563
Phone (574) 941-3111

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

Interoperability endpoints

  • Direct secure messaging: dawn.campbell@directsjpn.mhin.net
  • Direct secure messaging: dcampbell1147697@direct.trinity-health.org

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1629514799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1987 3B RD",
            "city": "BREMEN",
            "state": "IN",
            "postal_code": "465069779",
            "telephone_number": "574-209-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 LAKE AVE STE 100",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465637836",
            "telephone_number": "574-948-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "M.S.N./F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-13",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28123044A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dawn.campbell@directsjpn.mhin.net",
            "affiliation": "N",
            "endpointDescription": "sjrmc direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2349 Lake Ave Ste 100",
            "city": "Plymouth",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465637836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, IN

Sources for this page

Verify at the official NPI Registry.