Individual provider Active NPI

Dianne Q Campbell, MD

  • Family Medicine Physician
  • Savannah, GA
National Provider Identifier
1942224019
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036933 Issued in GA
Practice address
1170 Shawnee St
Savannah, GA 31419-1618
Phone
(912) 920-0214
NPI assigned
Jul 26, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 036933 GA Primary

Addresses

Primary practice location

1170 Shawnee St
Savannah, GA 31419-1618

Mailing address

1170 Shawnee St
Savannah, GA 31419-1618
Phone (912) 920-0214

Other identifiers 2

IdentifierTypeStateIssuer
00557334BMedicaidGA
08BBWKCOtherGAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100223000015 GA Practitioner - Hospice/Palliative CarePractitioner - Family Practice 1951445477 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23374SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Center for Palliative Care CurrentSince Oct 1, 2022 Accepting new patients
Hospice Savannah, Inc Family Medicine CurrentSince Oct 1, 2022 Accepting new patients

Locations

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

1352 Eisenhower Dr
Savannah, GA 31406
Phone (912) 354-8014

225 Candler Dr
Ste 301
Savannah, GA 31405
Phone (912) 354-8014

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

Organizations & group practices 2

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942224019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 SHAWNEE ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191618",
            "telephone_number": "912-920-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 SHAWNEE ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191618",
            "telephone_number": "912-920-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DIANNE",
        "middle_name": "Q",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "036933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00557334B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "08BBWKC",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.