NPIMap

Individual provider Active NPI

Mary M Campbell, MD

  • Family Medicine Physician
  • Bettendorf, IA
National Provider Identifier
1760470454
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26139 Issued in IA
Practice address
2140 53Rd Ave
Bettendorf, IA 52722-6279
Phone
(563) 421-5700
Fax
(563) 421-5709
NPI assigned
Oct 7, 2005
Last updated
Apr 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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 26139 IA Primary

Addresses

Primary practice location

2140 53Rd Ave
Bettendorf, IA 52722-6279

Mailing address

865 Lincoln Rd
Ste L10
Bettendorf, IA 52722-4190
Phone (563) 355-9191

Other identifiers 2

IdentifierTypeStateIssuer
06392OtherIAWELLMARK HEALTH PLAN
IA01N1OtherJOHN DEERE HEALTH PLAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mary.campbell@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20051018000088 IA Practitioner - Family Practice 4284691817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians
Quad City Physical Therapy and SpineGroup PAC ID 1850332651, 29 clinicians

Practice addresses (Care Compare)

1227 E Rusholme St
Davenport, IA 52803-2459

2140 53Rd Ave
Bettendorf, IA 52722-6279
Phone (563) 421-5700

5254 Utica Ridge Rd
Davenport, IA 52807-3872
Phone (563) 359-3799

619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26139IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System Family Medicine CurrentSince Jul 1, 2006 Accepting new patients
Genesis Health System CurrentSince Jul 1, 2006 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Genesis Health System Family Medicine Past Accepting new patients
Genesis Health System Past Accepting new patients
Genesis Health System Family Medicine PastSince Aug 4, 2025 Accepting new patients

Locations

2140 53rd Ave
Bettendorf, IA 52722
Phone (563) 421-5700

4017 Devils Glen Rd
Ste 100
Bettendorf, IA 52722
Phone (319) 332-6387

865 Lincoln Rd
Ste L10
Bettendorf, IA 52722
Phone (563) 355-9191

1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

1008 11th St
De Witt, IA 52742
Phone (563) 659-9137

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Interoperability endpoints

  • Direct secure messaging: mary.campbell@direct.genesishealth.com

Organizations & group practices 8

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1760470454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 LINCOLN RD",
            "address_2": "STE L10",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224190",
            "telephone_number": "563-355-9191",
            "fax_number": "563-355-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527226279",
            "telephone_number": "563-421-5700",
            "fax_number": "563-421-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-07",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "26139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK HEALTH PLAN",
            "identifier": "06392",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH PLAN",
            "identifier": "IA01N1",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mary.campbell@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "genesis health system direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccda",
            "address_1": "2140 53rd Ave",
            "city": "Bettendorf",
            "state": "IA",
            "country_code": "US",
            "postal_code": "527226279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.