Individual provider Active NPI

Lauree Danielle Cameron, PA

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1487807384
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1150 Issued in TN
Practice address
9430 Park West Blvd Ste 130
Knoxville, TN 37923-4205
Phone
(865) 690-4861
Fax
(865) 560-8525
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1150 TN
Surgical Physician Assistant 363AS0400X 1150 TN
Physician Assistant 363A00000X 1150 TN Primary

Addresses

Primary practice location

9430 Park West Blvd Ste 130
Knoxville, TN 37923-4205

Mailing address

363 W Main St
Lewisville, TX 75057-3867
Phone (972) 436-4434

Other practice location 1

9430 Park West Blvd
Suite 130
Knoxville, TN 37923-4200
Phone (865) 690-4861

Other identifiers 2

IdentifierTypeStateIssuer
1509729MedicaidTN
P00691294OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1341COMDClinical Social Worker
1150TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dny Medical Services, PLLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

4322 W Highway 82
Apt 1
Gainesville, TX 76240
Phone (940) 665-6060

363 W Main St
Lewisville, TX 75057
Phone (214) 734-7623

Organizations & group practices 1

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": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1487807384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 W MAIN ST",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573867",
            "telephone_number": "972-436-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 PARK WEST BLVD STE 130",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234205",
            "telephone_number": "865-690-4861",
            "fax_number": "865-560-8525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9430 Park West Blvd",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379234200",
            "country_code": "US",
            "telephone_number": "865-690-4861",
            "fax_number": "865-560-8525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "LAUREE",
        "middle_name": "DANIELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1150",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "1150",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509729",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00691294",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.