NPIMap

Individual provider Active NPI

Cameron Michael, DO

  • Neurology Physician
  • Jackson, TN
National Provider Identifier
1205323433
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4785 Issued in TN
Practice address
700 W Forest Ave Ste 200
Jackson, TN 38301-3940
Phone
(315) 419-4907
NPI assigned
Apr 13, 2018
Last updated
Dec 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Neurology Physician 2084N0400X 4785 TN Primary

Addresses

Primary practice location

700 W Forest Ave Ste 200
Jackson, TN 38301-3940

Mailing address

700 W Forest Ave Ste 200
Jackson, TN 38301-3940
Phone (315) 419-4907

Other practice location 1

625 19th St S
Birmingham, AL 35233-1900
Phone (205) 975-3509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220707004146 TN Practitioner - Neurology 2567842545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

700 W Forest Ave
Jackson, TN 38301-3937

72 Physicians Dr
Jackson, TN 38305-2070
Phone (731) 541-9490

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc Neurology Current Accepting new patients
Jackson Surgical Associates. PA Past Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

700 W Forest Ave
Ste 200
Jackson, TN 38301
Phone (731) 423-1267

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

Interoperability endpoints

  • Direct secure messaging: cmichael26742@directepic.wth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1205323433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W FOREST AVE STE 200",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013940",
            "telephone_number": "315-419-4907",
            "fax_number": "731-541-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W FOREST AVE STE 200",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013940",
            "telephone_number": "315-419-4907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-975-3509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "CAMERON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-13",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "4785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.