Individual provider Active NPI

Luis Camacho, M.A. F-AAA

  • Audiologist
  • Bloomington, IN
National Provider Identifier
1316213721
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
23002050A Issued in IN
Practice address
2011 N. Locust CT.
Bloomington, IN 47401
Phone
(812) 320-3817
NPI assigned
Mar 29, 2012
Last updated
Mar 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 23002050A IN Primary

Addresses

Primary practice location

2011 N. Locust CT.
Bloomington, IN 47401

Mailing address

2011 N Locust CT
Bloomington, IN 47401-6755

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
23002050AINMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1316213721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 N LOCUST CT",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474016755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 N. LOCUST CT.",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "47401",
            "telephone_number": "812-320-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "M.A. F-AAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002050A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; 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.