NPIMap

Organization Active NPI

Camille D Dillard

Doing business as Camille Dillard DO

  • Family Medicine Physician
  • Rome, NY
National Provider Identifier
1194916460
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
205458 Issued in NY
Legal business name
CAMILLE D DILLARD
Doing business as
Camille Dillard DO
Practice address
900 Erie Blvd W
Rome, NY 13440-2904
Phone
(888) 338-9355
Fax
(315) 337-2947
NPI assigned
Aug 5, 2007
Last updated
Mar 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Dr. Camille D Dillard, DONPI 1104815364
Title
Physician Owner
Phone
(888) 338-9355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 205458 NY Primary

Addresses

Primary practice location

900 Erie Blvd W
Rome, NY 13440-2904

Mailing address

PO Box 95
New York Mills, NY 13417-0095
Phone (315) 736-2080

Other identifiers 1

IdentifierTypeStateIssuer
02302578MedicaidNY

Other names 1

  • Camille Dillard DO Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1194916460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "NEW YORK MILLS",
            "state": "NY",
            "postal_code": "134170095",
            "telephone_number": "315-736-2080",
            "fax_number": "315-736-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ERIE BLVD W",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402904",
            "telephone_number": "888-338-9355",
            "fax_number": "315-337-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMILLE D DILLARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "DILLARD",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "888-338-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "205458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02302578",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camille Dillard DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.