Camille Franncine Bolton, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTO14539 Issued in GA

Practice address

500 Floy Farr Parkway
Suite 303
Fayetteville, GA 30214

Phone

(404) 539-0337

NPI assigned

Jun 23, 2020

Last updated

Jun 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Luna Care Physical Therapy LLCGroup PAC ID 4082027727, 167 clinicians

Leger Therapy Services Inc.Group PAC ID 6406853415, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1245826999
  Medicare reassignment Care Compare group NPD
• Leger Therapy Services Inc.

  dba CenterIMTAtlanta

  • Physical Therapy Clinic/Center
  • Fayetteville, GA
  • NPI 1659327666
  Medicare reassignment Care Compare group NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1922018423
  Medicare reassignment
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Lithonia, GA
  • NPI 1346119831
  NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Brookhaven, GA
  • NPI 1720097561
  NPD

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1194341412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 DEVILLA CT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303494027",
            "telephone_number": "404-539-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FLOY FARR PARKWAY",
            "address_2": "SUITE 303",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "404-539-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "CAMILLE",
        "middle_name": "FRANNCINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PTO14539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Ocean Laboratory Services LLC
• Board of Commissioners of Fayette County (Fayette County EMS)
• Body in Balance Chiropractic & Wellness Center, LLC
• Body Revolution Healthcare Consultants
• Body Therapy by George Massages LLC
• Holliann Elizabeth Bolton, CNM
• Jazeel Rachel Bonner, BS, RBT
• Natalie Bernett Bonner, FNP
• Sheba M Bonner
• Loida E. Bonney, M.D.

• Physical Therapist in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.