Individual provider Active NPI

Brenna Marie Cameron, MD

  • Pediatrics Physician
  • Montrose, CO
National Provider Identifier
1447837844
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR.0073389 Issued in CO
Practice address
947 S 5TH St
Montrose, CO 81401-5716
Phone
(970) 249-2421
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0073389 CO Primary

Addresses

Primary practice location

947 S 5TH St
Montrose, CO 81401-5716

Mailing address

947 S 5TH St
Montrose, CO 81401-5716
Phone (970) 249-2421

Other practice location 1

242 Cottonwood St Ste 101
Delta, CO 81416-4404
Phone (970) 874-7552

Other practice location 2

906 S 4th St
Montrose, CO 81401-4226
Phone (970) 249-2421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20210914003902 CO Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7012313141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0073389COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montrose Memorial Hospital, Inc Past Accepting new patients
Pediatric Associates Prof LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brenna.cameron.1@11212.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1447837844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 S 5TH ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015716",
            "telephone_number": "970-249-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 S 5TH ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015716",
            "telephone_number": "970-249-2421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 Cottonwood St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Delta",
            "state": "CO",
            "postal_code": "814164404",
            "country_code": "US",
            "telephone_number": "970-874-7552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "906 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "CO",
            "postal_code": "814014226",
            "country_code": "US",
            "telephone_number": "970-249-2421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "BRENNA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-07-23",
        "certification_date": "2024-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0073389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

Verify at the official NPI Registry.