Individual provider Active NPI

Kelsey Fowler Cameron, PA-C

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1386174613
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9645 Issued in GA
Practice address
225 Candler Dr Ste 300
Savannah, GA 31405-6091
Phone
(912) 354-6187
NPI assigned
Jun 19, 2017
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110413 FL
Physician Assistant 363A00000X 9645 GA Primary

Addresses

Primary practice location

225 Candler Dr Ste 300
Savannah, GA 31405-6091

Mailing address

836 E 65TH St Ste 4
Savannah, GA 31405-4491
Phone (912) 354-6187

Other practice location 1

159 W Railroad St, Bldg B
Pembroke, GA 31321
Phone (912) 354-6187

Other practice location 2

1497 Fair Rd Ste 311
Statesboro, GA 30458-0828
Phone (912) 354-6187

Other practice location 3

1499 Fair Rd
Statesboro, GA 30458-1683
Phone (912) 354-6187

Other practice location 4

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 354-6187

Other practice location 5

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 354-6187

Other practice location 6

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 354-6187

Other practice location 7

459 Hwy 119 S
Springfield, GA 31329-3021
Phone (912) 800-6560

Other practice location 8

459 Hwy 119 S Ste B
Springfield, GA 31329-3021
Phone (912) 800-6560

Other identifiers 1

IdentifierTypeStateIssuer
022310500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200604003000 GA Practitioner - Physician Assistant 0345516969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
69.81 of 100Reported as group
Quality
58.86
Promoting interoperability
53
Improvement activities
40
Cost
70.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9110413FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Candler Medical Oncology Practice, LLC CurrentSince Apr 1, 2020 Accepting new patients

Locations

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

225 Candler Dr
Ste 300
Savannah, GA 31405

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

5400 Sutlive St
Savannah, GA 31405
Phone (912) 201-3825

836 E 65th St
Ste 4
Savannah, GA 31405
Phone (912) 303-1309

1497 Fair Rd
Ste 311
Statesboro, GA 30458
Phone (340) 643-2227

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/candler-47b034e8

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1386174613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E 65TH ST STE 4",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054491",
            "telephone_number": "912-354-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CANDLER DR STE 300",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056091",
            "telephone_number": "912-354-6187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "159 W Railroad St, Bldg B",
            "address_purpose": "LOCATION",
            "city": "Pembroke",
            "state": "GA",
            "postal_code": "31321",
            "country_code": "US",
            "telephone_number": "912-354-6187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1497 Fair Rd Ste 311",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304580828",
            "country_code": "US",
            "telephone_number": "912-354-6187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1499 Fair Rd",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304581683",
            "country_code": "US",
            "telephone_number": "912-354-6187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5353 Reynolds St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056015",
            "country_code": "US",
            "telephone_number": "912-354-6187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11705 Mercy Blvd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314191711",
            "country_code": "US",
            "telephone_number": "912-354-6187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-354-6187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "459 Hwy 119 S",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "GA",
            "postal_code": "313293021",
            "country_code": "US",
            "telephone_number": "912-800-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "459 Hwy 119 S Ste B",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "GA",
            "postal_code": "313293021",
            "country_code": "US",
            "telephone_number": "912-800-6560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "KELSEY",
        "middle_name": "FOWLER",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110413",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022310500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.