Individual provider Active NPI

Cameron Collier

  • Physician Assistant
  • Bowling Green, KY
National Provider Identifier
1255056446
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC328 Issued in KY
Practice address
1065 Ashley St
Bowling Green, KY 42103-3400
Phone
(270) 843-3376
NPI assigned
Oct 10, 2022
Last updated
Nov 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC328 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X KY

Addresses

Primary practice location

1065 Ashley St
Bowling Green, KY 42103-3400

Mailing address

201 Park St
Bowling Green, KY 42101-1708
Phone (270) 781-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222000326 KY Practitioner - Physician Assistant 0345610028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

1065 Ashley St
Suite 200
Bowling Green, KY 42103-3401
Phone (270) 843-3376

201 Park St
Bowling Green, KY 42101-1742
Phone (270) 781-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Jan 2, 2023 Accepting new patients
Graves Gilbert Clinic PLLC Physician Assistant CurrentSince Jan 2, 2023 Accepting new patients

Locations

1065 Ashley St
Ste 2
Bowling Green, KY 42103

1065 Ashley St
Ste 200
Bowling Green, KY 42103
Phone (270) 843-3376

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

Interoperability endpoints

  • Direct secure messaging: cameroncollier@ggc.allscriptsdirect.net

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1255056446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011708",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 ASHLEY ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033400",
            "telephone_number": "270-843-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "CAMERON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC328",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.