Active NPI
Camilla A Raines, PA
- Physician Assistant
- Colorado Springs, CO
National Provider Identifier
1184673741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-644
- Practice address
- 2828 International Cir
Suite 140
Colorado Springs, CO 80910-3127 - Phone
- (719) 632-5700
- Fax
- (719) 344-7821
- NPI assigned
- May 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-644 | CO | Primary |
Addresses
Primary practice location
2828 International Cir
Suite 140
Colorado Springs, CO 80910-3127
Mailing address
3205 N Academy Blvd
Suite 130
Colorado Springs, CO 80917-5101
Phone (719) 632-5700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16830351 | Medicaid | CO |
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-644 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Front Range Emergency Specialists, PC | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Colorado Springs, CO
- NPI 1538233234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418083200000",
"number": "1184673741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3205 N ACADEMY BLVD",
"address_2": "SUITE 130",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809175101",
"telephone_number": "719-632-5700",
"fax_number": "719-344-7837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2828 INTERNATIONAL CIR",
"address_2": "SUITE 140",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103127",
"telephone_number": "719-632-5700",
"fax_number": "719-344-7821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAINES",
"first_name": "CAMILLA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-09",
"last_updated": "2014-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA-644",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16830351",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.