NPIMap

Individual provider Active NPI

Sonya C Camilli, PA-C

  • Medical Physician Assistant
  • Ludington, MI
National Provider Identifier
1154328573
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004803 Issued in MI
Practice address
7 Atkinson Dr
Ludington, MI 49431-1953
Phone
(231) 843-3487
Fax
(231) 843-4525
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601004803 MI Primary

Addresses

Primary practice location

7 Atkinson Dr
Ludington, MI 49431-1953

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL scamilli106458@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090112000432 MI Practitioner - Physician Assistant 8820989148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Medical Center of West MichiganGroup PAC ID 3678543659, 62 clinicians

Practice addresses (Care Compare)

1 Atkinson Dr
Ludington, MI 49431-1906
Phone (231) 843-2591

7 Atkinson Dr
Ludington, MI 49431-1953

Hospital & facility affiliations

  • Corewell Health Ludington Hospital Hospital, Ludington, MI, CCN 230110
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center of West Michigan CurrentSince Jun 2, 2014 Accepting new patients
Spectrum Health Primary Care Partners Past Accepting new patients
Hillsboro Neurosurgical Associates, PC Past Accepting new patients

Locations

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

7 Atkinson Dr
Ste 111
Ludington, MI 49431
Phone (231) 733-2008

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

220 S James St
Ludington, MI 49431
Phone (231) 843-3700

7 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2664

Interoperability endpoints

  • Direct secure messaging: scamilli106458@epic00.corewelldirect.org

Organizations & group practices 9

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 3

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1154328573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ATKINSON DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311953",
            "telephone_number": "231-843-3487",
            "fax_number": "231-843-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMILLI",
        "first_name": "SONYA",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "scamilli106458@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "7 Atkinson Dr",
            "city": "Ludington",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494311953",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "7 Atkinson Dr",
            "city": "Ludington",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494311953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

Verify at the official NPI Registry.