Individual provider Active NPI

Cameron Mitchell Thurman, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Lackland AFB, TX
National Provider Identifier
1548453319
Registry record updated Aug 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2200 Bergquist Dr
Suite 1, Attn Credentials
Lackland AFB, TX 78236-9907
Phone
(210) 467-5080
NPI assigned
Aug 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2200 Bergquist Dr
Suite 1, Attn Credentials
Lackland AFB, TX 78236-9907

Mailing address

50 Sable Cyn
San Antonio, TX 78258-4857
Phone (210) 467-5080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20170106000949 VA Practitioner - Emergency Medicine 1456632470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical University of South Carolina College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

1500 Commonwealth Ave
Williamsburg, VA 23185-5229
Phone (757) 585-2250

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc CurrentSince Nov 7, 2016 Accepting new patients
Riverside Physician Services Inc CurrentSince Nov 7, 2016 Accepting new patients

Locations

1500 Commonwealth Ave
Williamsburg, VA 23185
Phone (757) 585-2200

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": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187913600000",
    "number": "1548453319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 SABLE CYN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584857",
            "telephone_number": "210-467-5080",
            "fax_number": "210-467-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "SUITE 1, ATTN CREDENTIALS",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-467-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURMAN",
        "first_name": "CAMERON",
        "middle_name": "MITCHELL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland AFB, TX

Sources for this page

Verify at the official NPI Registry.