Individual provider Active NPI

Mary Lynn Campbell, M.D.

  • Obstetrics & Gynecology Physician
  • Snellville, GA
National Provider Identifier
1801888516
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
032526 Issued in GA
Practice address
1700 Tree Lane Rd
Suite 290
Snellville, GA 30078-6782
Phone
(770) 972-0330
Fax
(770) 985-2683
NPI assigned
Aug 18, 2005
Last updated
Jan 29, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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 032526 GA Primary

Addresses

Primary practice location

1700 Tree Lane Rd
Suite 290
Snellville, GA 30078-6782

Mailing address

1700 Tree Lane Rd
Suite 290
Snellville, GA 30078-6782
Phone (770) 972-0330

Other identifiers 1

IdentifierTypeStateIssuer
00432132AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032526GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett OB-GYN Associates, P.C.. Obstetrics & Gynecology Current Accepting new patients

Locations

1700 Tree Ln
Ste 290
Snellville, GA 30078
Phone (770) 972-0330

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1801888516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TREE LANE RD",
            "address_2": "SUITE 290",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786782",
            "telephone_number": "770-972-0330",
            "fax_number": "770-985-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TREE LANE RD",
            "address_2": "SUITE 290",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786782",
            "telephone_number": "770-972-0330",
            "fax_number": "770-985-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "032526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00432132A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.