Individual provider Active NPI

Cameron Taube, PA-C

  • Physician Assistant
  • Conyers, GA
National Provider Identifier
1063226207
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1301 Sigman Rd NE Ste 190
Conyers, GA 30012-3924
Phone
(678) 806-3566
NPI assigned
Feb 6, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X GA Primary

Addresses

Primary practice location

1301 Sigman Rd NE Ste 190
Conyers, GA 30012-3924

Mailing address

4110 Old Montgomery Hwy
Birmingham, AL 35229-0001
Phone (205) 726-4512

Other practice location 1

4110 Old Montgomery Hwy
Birmingham, AL 35229-0001
Phone (205) 726-4512

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250709002444 GA Practitioner - Physician Assistant 9436663697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

1301 Sigman Rd NE
Suite 170
Conyers, GA 30012-3923
Phone (678) 806-3690

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

1984 Peachtree Rd NW
Suite 300
Atlanta, GA 30309-5219
Phone (404) 367-3210

Hospital & facility affiliations

  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1063226207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 OLD MONTGOMERY HWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352290001",
            "telephone_number": "205-726-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SIGMAN RD NE STE 190",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123924",
            "telephone_number": "678-806-3566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4110 Old Montgomery Hwy",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352290001",
            "country_code": "US",
            "telephone_number": "205-726-4512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAUBE",
        "first_name": "CAMERON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.