Individual provider Active NPI

Cameron L Coury, MD

  • Dermatology Physician
  • Richardson, TX
National Provider Identifier
1104020767
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
N3580 Issued in TX
Practice address
3005 E. Renner Road
Ste 100
Richardson, TX 75082
Phone
(972) 699-0000
Fax
(972) 699-0004
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X BP1-0022965 TX
Dermatology Physician 207N00000X N3580 TX Primary

Addresses

Primary practice location

3005 E. Renner Road
Ste 100
Richardson, TX 75082

Mailing address

3005 E. Renner Road
Ste 100
Richardson, TX 75082
Phone (972) 699-0000

Other identifiers 1

IdentifierTypeStateIssuer
2791935608OtherMYUTMB 2791935608-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100415000979 TX Practitioner - Dermatology 4981731395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at Houston, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Specialists, PAGroup PAC ID 8527011857, 5 clinicians

Practice addresses (Care Compare)

3005 E Renner Rd
Suite 100
Richardson, TX 75082-3570
Phone 97269900003684

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions399
Skin biopsy69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP1-0022965TXMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Specialists, PA Dermatology CurrentSince Feb 15, 2010 Accepting new patients

Locations

3005 E Renner Rd
Richardson, TX 75082
Phone (972) 699-0000

3005 E Renner Rd
Ste 100
Richardson, TX 75082
Phone (972) 699-0000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJJJAA
  • Direct secure messaging: cameronc@dermspecialiststx.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264636800000",
    "number": "1104020767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 E. RENNER ROAD",
            "address_2": "STE 100",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75082",
            "telephone_number": "972-699-0000",
            "fax_number": "972-699-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 E. RENNER ROAD",
            "address_2": "STE 100",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75082",
            "telephone_number": "972-699-0000",
            "fax_number": "972-699-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURY",
        "first_name": "CAMERON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2010-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "TX",
            "license": "BP1-0022965",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N3580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 2791935608-COMMERCIAL NUMBER",
            "identifier": "2791935608",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.