NPIMap

Individual provider Active NPI

Jeffrey Dale Camp

  • Pharmacist
  • Decatur, AL
National Provider Identifier
1225197478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11294 Issued in AL
Practice address
1517 Moulton St W
Decatur, AL 35601-2149
Phone
(256) 355-1815
Fax
(256) 350-5300
NPI assigned
Dec 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11294 AL Primary

Addresses

Primary practice location

1517 Moulton St W
Decatur, AL 35601-2149

Mailing address

1517 Moulton St W
Decatur, AL 35601-2149
Phone (256) 355-1815

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11294ALMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Payless Pharmacy Express #2, Inc Current Accepting new patients
Payless Pharmacy Express #2, Inc Current Accepting new patients

Locations

1517 Moulton St W
Decatur, AL 35601
Phone (256) 355-1815

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225197478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 MOULTON ST W",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012149",
            "telephone_number": "256-355-1815",
            "fax_number": "256-350-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 MOULTON ST W",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012149",
            "telephone_number": "256-355-1815",
            "fax_number": "256-350-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMP",
        "first_name": "JEFFREY",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "11294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.