Individual provider Active NPI

Cameron Wilcox, MD

  • Psychiatry Physician
  • Marquette, MI
National Provider Identifier
1386867711
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301082621 Issued in MI
Practice address
200 W Spring St
Marquette, MI 49855-4630
Phone
(906) 233-1236
Fax
(906) 233-1235
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician 2084D0003X 4301082621 MI
Psychiatry Physician 2084P0800X 4301082621 MI Primary

Addresses

Primary practice location

200 W Spring St
Marquette, MI 49855-4630

Mailing address

200 W Spring St
Marquette, MI 49855-4630
Phone (906) 233-1236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20070516000030 MI Practitioner - Psychiatry 8123125713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Human Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1400 W Washington St
Marquette, MI 49855-3116
Phone (906) 449-1600

1414 W Fair Ave
Marquette, MI 49855-2675

850 W Baraga Ave
Marquette, MI 49855-4550

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
DLP Marquette Physician Practices Inc Past Accepting new patients

Locations

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

1400 W Washington St
Marquette, MI 49855
Phone (906) 449-1460

1414 W Fair Ave
Ste 344
Marquette, MI 49855
Phone (906) 225-3910

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

200 W Spring St
Marquette, MI 49855
Phone (906) 225-1181

Interoperability endpoints

  • Direct secure messaging: cameron.wilcox.1@8233.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.

Hospital & facility affiliations 1

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1386867711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W SPRING ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554630",
            "telephone_number": "906-233-1236",
            "fax_number": "906-233-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W SPRING ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554630",
            "telephone_number": "906-233-1236",
            "fax_number": "906-233-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "CAMERON",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084D0003X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": "MI",
            "license": "4301082621",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301082621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.