NPIMap

Organization Active NPI

The Camellia Foundation

Doing business as Clinica Camellia

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1609169713
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13931 Issued in TN
Legal business name
THE CAMELLIA FOUNDATION
Doing business as
Clinica Camellia
Practice address
3030 Covington Pike
Suite 200
Memphis, TN 38128-5048
Phone
(901) 432-5727
Fax
(901) 384-6309
NPI assigned
May 23, 2011
Last updated
Jun 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Authorized official

Name
Mrs. Camellia Rodney, RN
Title
President
Phone
(901) 753-0423

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13931 TN Primary
Obstetrics & Gynecology Physician 207V00000X 40403 TN
Pediatrics Physician 208000000X 40403 TN

Addresses

Primary practice location

3030 Covington Pike
Suite 200
Memphis, TN 38128-5048

Mailing address

3030 Covington Pike
Suite 200
Memphis, TN 38128-5048
Phone (901) 432-5727

Other names 1

  • Clinica Camellia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110805000223 TN Part B Supplier - Clinic/Group Practice 0547439606 Receives reassigned benefits from 41 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

3030 Covington Pike
#200
Memphis, TN 38128
Phone (901) 432-5727

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1609169713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 COVINGTON PIKE",
            "address_2": "SUITE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285048",
            "telephone_number": "901-432-5727",
            "fax_number": "901-384-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 COVINGTON PIKE",
            "address_2": "SUITE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285048",
            "telephone_number": "901-432-5727",
            "fax_number": "901-384-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CAMELLIA FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-23",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "RODNEY",
        "authorized_official_first_name": "CAMELLIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-753-0423",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "13931",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "40403",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "40403",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Camellia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.