Individual provider Active NPI

Paige Grace Cameron

  • Speech-Language Pathologist
  • Clayton, NC
National Provider Identifier
1417695461
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30001038 Issued in NC
Practice address
195 Springbrook Ave
Clayton, NC 27520-8105
Phone
(919) 550-7200
NPI assigned
May 20, 2022
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU
Speech-Language Pathologist 235Z00000X 30001038 NC Primary

Addresses

Primary practice location

195 Springbrook Ave
Clayton, NC 27520-8105

Mailing address

9 Judy CT
Centerport, NY 11721-1157
Phone (631) 742-3103

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231012000566 WI Practitioner - Qualified Speech Language Pathologist 1052766904 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians

Practice addresses (Care Compare)

5715 N Meade St
Appleton, WI 54913-8364
Phone (608) 344-2495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30001038NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC Speech-Language Pathologist CurrentSince Sep 5, 2023 Accepting new patients
Empowerme Rehabilitation, LLC Speech-Language Pathologist CurrentSince Feb 10, 2024 Accepting new patients
Paxxon Healthcare Services LLC CurrentSince Sep 5, 2023 Accepting new patients
Empowerme Rehabilitation, LLC Speech-Language Pathologist CurrentSince Feb 10, 2024 Accepting new patients
Onr National Speech Pathology Inc CurrentSince Feb 10, 2024 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

6801 W Loomis Rd
Greendale, WI 53129
Phone (414) 209-3132

1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207

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, 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": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1417695461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 JUDY CT",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211157",
            "telephone_number": "631-742-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 SPRINGBROOK AVE",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208105",
            "telephone_number": "919-550-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "PAIGE",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30001038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.