Camille Nina Immanuel, MD MHS

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

10549592-1205 Issued in UT

Practice address

4100 Cobscook Dr
Durham, NC 27707-5706

Phone

(276) 451-4700

Fax

(276) 451-4700

NPI assigned

Jun 26, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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 and National Provider Directory roles.

• Dell Children'S Medical Group

  • Pediatrics Physician
  • Austin, TX
  • NPI 1326072943
  Medicare reassignment NPD
• Dell Children'S Medical Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Austin, TX
  • NPI 1124748249
  NPD

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

{
    "created_epoch": "1309046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1295021483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 SYCAMORE RD",
            "address_2": "APT C",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070127330",
            "telephone_number": "276-451-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 COBSCOOK DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075706",
            "telephone_number": "276-451-4700",
            "fax_number": "276-451-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMANUEL",
        "first_name": "CAMILLE",
        "middle_name": "NINA",
        "name_prefix": "Dr.",
        "credential": "MD MHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-26",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "39",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "UT",
            "license": "10549592-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STUDENT & EDUCATION",
            "identifier": "#39",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chioma E Iloabachie, NP
• Images , 'of Me to You'
• Imagine House
• Imagine Pediatrics of North Carolina, PLLC
• Imani & Co. Living LLC
• Immunovia, Inc.
• Impact Community and Coordinated Services, LLC
• Impact Therapy Services
• Imperial Center Family Medicine and Immediate Care PLLC
• In Home Care Services, LLC

• Pediatric Critical Care Medicine Physician in Durham, NC
• Providers in Durham, NC by specialty
• Pediatric Critical Care Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.