Active NPI
Brittany Arlene Camille, FNP-BC, RN
- Nurse Practitioner
- Riverside, CA
National Provider Identifier
1346940947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95024692
- Practice address
- 11357 Lakeport Dr
Riverside, CA 92505-3470 - Phone
- (310) 344-1027
- NPI assigned
- Mar 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 803915 | CA | |
| Nurse Practitioner | 363L00000X | 95024692 | CA | Primary |
Addresses
Primary practice location
11357 Lakeport Dr
Riverside, CA 92505-3470
Mailing address
11357 Lakeport Dr
Riverside, CA 92505-3470
Phone (310) 344-1027
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95024692 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unicare Community Health Center Inc | Current | Accepting new patients | |
| Unicare Community Health Center, Inc. | Current | Accepting new patients | |
| Altais Medical Group - Riverside, Inc. | Past | Accepting new patients |
Locations
17500 Foothill Blvd
Ste A2
Fontana, CA 92335
Phone (909) 428-0170
437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835
Interoperability endpoints
- brittany.camille.2@24668.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Riverside, CA
- NPI 1639066491
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1861925679
-
- Family Medicine Physician
- Riverside, CA
- NPI 1518629575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682985600000",
"number": "1346940947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11357 LAKEPORT DR",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925053470",
"telephone_number": "310-344-1027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11357 LAKEPORT DR",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925053470",
"telephone_number": "310-344-1027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMILLE",
"first_name": "BRITTANY",
"middle_name": "ARLENE",
"name_prefix": "Dr.",
"credential": "FNP-BC, RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-03",
"last_updated": "2023-05-02",
"certification_date": "2023-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "803915",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95024692",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95024692",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.