Individual provider Active NPI

Cameron Mitchell Dudley, D.C.

  • Chiropractor
  • Las Vegas, NV
National Provider Identifier
1467591297
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
B00447 Issued in NV
Practice address
7240 W Lake Mead Blvd
Suite 3
Las Vegas, NV 89128-8356
Phone
(702) 453-0440
Fax
(702) 453-0550
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X B00447 NV Primary

Addresses

Primary practice location

7240 W Lake Mead Blvd
Suite 3
Las Vegas, NV 89128-8356

Mailing address

7240 W Lake Mead Blvd
Suite 3
Las Vegas, NV 89128-8356
Phone (702) 453-0440

Other identifiers 1

IdentifierTypeStateIssuer
3602060MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120709000170 NV Practitioner - Chiropractic 8527157528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burke Spinal Care LTDGroup PAC ID 6103803796, 2 clinicians

Practice addresses (Care Compare)

2650 S Maryland Pkwy
Suite A2
Las Vegas, NV 89109-1665
Phone (702) 453-0440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burke Spinal Care, LTD Chiropractor CurrentSince Jan 1, 1990 Accepting new patients
Burke Spinal Care, LTD Chiropractor CurrentSince Jan 1, 1990 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients

Locations

7240 W Lake Mead Blvd
Ste 3
Las Vegas, NV 89128
Phone (702) 453-0440

2650 S Maryland Pkwy
Ste A2
Las Vegas, NV 89109
Phone (702) 453-0440

Organizations & group practices 6

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1467591297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7240 W LAKE MEAD BLVD",
            "address_2": "SUITE 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891288356",
            "telephone_number": "702-453-0440",
            "fax_number": "702-453-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7240 W LAKE MEAD BLVD",
            "address_2": "SUITE 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891288356",
            "telephone_number": "702-453-0440",
            "fax_number": "702-453-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "CAMERON",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B00447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3602060",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.