Cameron Elizabeth Wold, AGACNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

2015021575 Issued in IA

Practice address

1100 NW South Outer Rd Ste 200
Blue Springs, MO 64015-3069

Phone

(888) 256-3814

Fax

(888) 256-9054

NPI assigned

Jan 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Cameron Elizabeth Broihier Former name

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1558728030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NW SOUTH OUTER RD STE 200",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153069",
            "telephone_number": "888-256-3814",
            "fax_number": "888-256-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NW SOUTH OUTER RD STE 200",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153069",
            "telephone_number": "888-256-3814",
            "fax_number": "888-256-9054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3211 S 26th Ave",
            "address_purpose": "LOCATION",
            "city": "Eldridge",
            "state": "IA",
            "postal_code": "527489304",
            "country_code": "US",
            "telephone_number": "563-723-1650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLD",
        "first_name": "CAMERON",
        "middle_name": "ELIZABETH",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IA",
            "license": "2015021575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMERON",
            "last_name": "BROIHIER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Primary Care Nurse Practitioner in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Primary Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.