Individual provider Active NPI

Camille A. Drennan, PT, MSPT, MPA

  • Physical Therapist
  • Stuart, FL
National Provider Identifier
1083621197
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18834 Issued in FL
Practice address
835 SW Rustic Cir
Stuart, FL 34997-6235
Phone
(772) 286-3618
Fax
(772) 286-9535
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT18834 FL Primary
Pediatric Physical Therapist 2251P0200X PT18834 FL

Addresses

Primary practice location

835 SW Rustic Cir
Stuart, FL 34997-6235

Mailing address

835 SW Rustic Cir
Stuart, FL 34997-6235
Phone (772) 286-3618

Other identifiers 2

IdentifierTypeStateIssuer
886424100MedicaidFL
680687296MedicaidFL

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

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1083621197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SW RUSTIC CIR",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976235",
            "telephone_number": "772-286-3618",
            "fax_number": "772-286-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SW RUSTIC CIR",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976235",
            "telephone_number": "772-286-3618",
            "fax_number": "772-286-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRENNAN",
        "first_name": "CAMILLE",
        "middle_name": "A.",
        "credential": "PT, MSPT, MPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18834",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT18834",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886424100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "680687296",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.