Camille Collett, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1714781205 Issued in UT

Practice address

1250 E 3900 S
Suite 260
Salt Lake City, UT 84124-1348

Phone

(801) 265-2000

Fax

(801) 506-0296

NPI assigned

Jul 5, 2005

Last updated

Oct 24, 2015By 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 UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Utah Healthcare Institute Inc

  dba St. Mark's Family Medicine

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1376597344
  Medicare reassignment NPD
• Mountainstar Medical Group-St. Marks Hospital, LLC

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1073795258
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445644800000",
    "number": "1275530305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S",
            "address_2": "SUITE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241348",
            "telephone_number": "801-265-2000",
            "fax_number": "801-506-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S",
            "address_2": "SUITE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241348",
            "telephone_number": "801-265-2000",
            "fax_number": "801-506-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETT",
        "first_name": "CAMILLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2015-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "1714781205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Colipi
• Brenda Colledge
• College of Nursing University of Utah
• Pace Anthony Collester
• Keegan J. Colletier, MD
• Tess Collett, PHD
• Andre Collette
• Jessica Collette
• Adam Joseph Collier
• Gail Patricia Collier, LCSW

• Family Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.