NPIMap

Individual provider Active NPI

Kelly M Campbell, MD

  • Obstetrics & Gynecology Physician
  • West Bloomfield, MI
National Provider Identifier
1689608093
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
KC061242 Issued in MI
Practice address
5777 W Maple Rd
Suite 200
West Bloomfield, MI 48322-2267
Phone
(248) 932-9223
Fax
(248) 932-8641
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X KC061242 MI Primary

Addresses

Primary practice location

5777 W Maple Rd
Suite 200
West Bloomfield, MI 48322-2267

Mailing address

5777 W Maple Rd
Suite 200
West Bloomfield, MI 48322-2267
Phone (248) 932-9223

Other identifiers 1

IdentifierTypeStateIssuer
KC061242OtherMISTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20101102001429 MI Practitioner - Obstetrics/Gynecology 0547294068 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Moca Group PCGroup PAC ID 3476570177, 9 clinicians

Practice addresses (Care Compare)

5777 W Maple Rd
Suite 200
West Bloomfield, MI 48322-2271
Phone (248) 932-9223

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
KC061242MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moca Group PC Obstetrics & Gynecology CurrentSince Mar 1, 2000 Accepting new patients
Henry Ford Health System CurrentSince Dec 17, 2018 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Obhg Michigan - Direct PC Obstetrics & Gynecology CurrentSince Oct 1, 2025 Accepting new patients
Henry Ford Health System Obstetrics & Gynecology CurrentSince Dec 17, 2018 Accepting new patients

Locations

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

5777 W Maple Rd
Ste 200
West Bloomfield, MI 48322
Phone (248) 932-9223

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: kcampbell59149@direct.hfhs.org
  • Direct secure messaging: kcampbel@direct.dmc.org

Organizations & group practices 5

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 6

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1689608093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 W MAPLE RD",
            "address_2": "SUITE 200",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222267",
            "telephone_number": "248-932-9223",
            "fax_number": "248-932-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 W MAPLE RD",
            "address_2": "SUITE 200",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222267",
            "telephone_number": "248-932-9223",
            "fax_number": "248-932-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "KC061242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "KC061242",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.