Individual provider Active NPI

Cami Lynn Watkins, M.D.

  • Internal Medicine Physician
  • Florissant, MO
National Provider Identifier
1376516427
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
108458 Issued in MO
Practice address
1120 Shackelford Rd
Florissant, MO 63031-4369
Phone
(314) 291-4420
Fax
(314) 921-6086
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 108458 MO Primary

Addresses

Primary practice location

1120 Shackelford Rd
Florissant, MO 63031-4369

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other identifiers 1

IdentifierTypeStateIssuer
110235596OtherMORAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cwatkins6037@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20060131000006 MO Practitioner - Internal Medicine 1850305723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

12255 De Paul Dr
Suite 600
Bridgeton, MO 63044-2515
Phone (314) 209-5100

326 E Main St
West Frankfort, IL 62896-2402
Phone (618) 937-6200

Hospital & facility affiliations

  • SSM Health at Home Home Health-St. Louis Home health agency, Saint Louis, MO, CCN 267184
  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
  • SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
108458MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Medical Group, Inc. Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
SSM Health Care St. Louis Internal Medicine Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients

Locations

12255 De Paul Dr
Ste 600
Bridgeton, MO 63044
Phone (314) 209-5100

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

1120 Shackelford Rd
Florissant, MO 63031
Phone (314) 830-5805

1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

Interoperability endpoints

  • Direct secure messaging: cwatkins6037@direct-ehr-ssmhc.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1376516427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 SHACKELFORD RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630314369",
            "telephone_number": "314-291-4420",
            "fax_number": "314-921-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "CAMI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "108458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110235596",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwatkins6037@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cwatkins6037@direct-ehr-ssmhc.com",
            "address_1": "1120 Shackelford Rd",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630314369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1120 Shackelford Rd",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630314369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.