Individual provider Active NPI

Cameron James Hummel, PT, DPT, LAT, ATC

  • Physical Therapist
  • Knightdale, NC
National Provider Identifier
1629798053
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21541 Issued in NC
Practice address
162 Legacy Oaks Dr # 2102
Knightdale, NC 27545-6556
Phone
(919) 373-1799
NPI assigned
Aug 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X LAT-4386 NC
Physical Therapist 225100000X P21541 NC Primary

Addresses

Primary practice location

162 Legacy Oaks Dr # 2102
Knightdale, NC 27545-6556

Mailing address

162 Legacy Oaks Dr # 2102
Knightdale, NC 27545-6556
Phone (919) 373-1799

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102000129 NC Practitioner - Physical Therapist in Private Practice 8123495280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

162 Legacy Oaks Dr
Knightdale, NC 27545-6556
Phone (919) 684-8111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAT-4386NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Sep 12, 2022 Accepting new patients
Duke University Health System, Inc. Physical Therapist CurrentSince Sep 12, 2022 Accepting new patients
Duke University Health System, Inc. PastSince Sep 4, 2022 Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

162 Legacy Oaks Dr
#2102
Knightdale, NC 27545
Phone (919) 373-1799

162 Legacy Oaks Dr
Ste 2102
Knightdale, NC 27545
Phone (919) 373-1799

162 Legacy Oaks Dr
Knightdale, NC 27545
Phone (919) 373-1800

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.

NPI Registry JSON

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1629798053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 LEGACY OAKS DR # 2102",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456556",
            "telephone_number": "919-373-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 LEGACY OAKS DR # 2102",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456556",
            "telephone_number": "919-373-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMEL",
        "first_name": "CAMERON",
        "middle_name": "JAMES",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-4386",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.