NPIMap

Individual provider Active NPI

Mark Rue Campbell, MD

  • Family Medicine Physician
  • Trenton, KY
National Provider Identifier
1730175910
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22075 Issued in KY
Practice address
120 N Main St
Trenton, KY 42286-9734
Phone
(270) 466-9300
Fax
(270) 466-3300
NPI assigned
Sep 23, 2005
Last updated
Aug 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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 22075 KY Primary

Addresses

Primary practice location

120 N Main St
Trenton, KY 42286-9734

Mailing address

PO Box 990
102 W 18TH Street
Hopkinsville, KY 42241-0990
Phone (270) 466-9300

Other practice location 1

10755 Eagle Way Ste 100
Hopkinsville, KY 42240-8742
Phone (270) 887-6813

Other identifiers 1

IdentifierTypeStateIssuer
64220759MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20031211000932 KY Practitioner - Family Practice 5092629089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jennie Stuart Medical Center IncGroup PAC ID 4183607252, 113 clinicians

Practice addresses (Care Compare)

10755 Eagle Way
Suite 100
Hopkinsville, KY 42240-8742
Phone (270) 887-0270

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22075KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jennie Stuart Medical Center Inc Family Medicine Current Accepting new patients
Jennie Stuart Medical Center Inc CurrentSince Dec 5, 2022 Accepting new patients
Jennie Stuart Medical Center Inc CurrentSince Dec 5, 2022 Accepting new patients
Commonwealth Health Corporation, Inc. Past Accepting new patients
Jennie Stuart Medical Center Past Accepting new patients

Locations

10755 Eagle Way
Ste 100
Hopkinsville, KY 42240
Phone (270) 887-0270

10755 Eagle Way
Ste 202
Hopkinsville, KY 42240
Phone (270) 887-5640

320 W 18th St
Hopkinsville, KY 42240
Phone (270) 887-0100

Interoperability endpoints

  • Direct secure messaging: mcampbell1012588@direct.deaconess.com

Organizations & group practices 6

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 3

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1730175910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990",
            "address_2": "102 W 18TH STREET",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422410990",
            "telephone_number": "270-466-9300",
            "fax_number": "270-466-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N MAIN ST",
            "city": "TRENTON",
            "state": "KY",
            "postal_code": "422869734",
            "telephone_number": "270-466-9300",
            "fax_number": "270-466-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10755 Eagle Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422408742",
            "country_code": "US",
            "telephone_number": "270-887-6813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARK",
        "middle_name": "RUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "22075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64220759",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, KY

Sources for this page

Verify at the official NPI Registry.