Active NPI
Dorthia D Cameron, NP
- Primary Care Nurse Practitioner
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 209030955
- Practice address
- 530 NE Glen Oak Ave
Peoria, IL 61637-0001 - Phone
- (309) 624-8820
- Fax
- (309) 624-8820
- NPI assigned
- Jan 9, 2016
- Last updated
- Jul 28, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 6647 | WI | |
| Primary Care Nurse Practitioner | 363LP2300X | 209030955 | IL | Primary |
Addresses
Primary practice location
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Mailing address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 624-8820
Other practice location 1
10400 75th St
Kenosha, WI 53142-7884
Phone (262) 948-7000
Other practice location 2
10400 75th St
Kenosha, WI 53142-7884
Phone (262) 948-7000
Other practice location 3
2514 S 102nd St Ste 160
West Allis, WI 53227-2142
Phone (414) 255-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100054093 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dwilson102724@aurora.direct-ci.com | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209030955 | IL | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vpa PC | Current | Accepting new patients | |
| Maple Medical SC | Current | Accepting new patients | |
| Vpa PC | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Vpa PC | Current | Accepting new patients | |
| Vpa PC | Current | Accepting new patients | |
| Oak Medical SC | Current | Accepting new patients | |
| Iah of Wisconsin, PLLC | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Milwaukee Cardiac Care LLC | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Past | Accepting new patients |
Locations
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000
13555 Bishops Ct
Ste 315
Brookfield, WI 53005
Phone (414) 255-0300
744 S Webster Ave
#2
Green Bay, WI 54301
110 Belmont Rd
Madison, WI 53714
Phone (308) 249-7391
2603 W Rawson Ave
Ste 135
Oak Creek, WI 53154
Phone (414) 271-8181
N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070
2514 S 102nd St
Ste 160
West Allis, WI 53227
Phone (414) 255-0300
Interoperability endpoints
- dwilson102724@aurora.direct-ci.com
Organizations & group practices 11
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba HarmonyCares Medical Group
- Family Medicine Physician
- Brookfield, WI
- NPI 1861898090
-
- Physical Medicine & Rehabilitation Physician
- Waukesha, WI
- NPI 1487152104
-
- Cardiovascular Disease Physician
- Milwaukee, WI
- NPI 1982625885
-
- Internal Medicine Physician
- Waukesha, WI
- NPI 1669910345
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
dba HarmonyCares Medical Group
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Brookfield, WI
- NPI 1376871947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753660800000",
"number": "1669838496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 NE GLEN OAK AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616370001",
"telephone_number": "309-624-8820",
"fax_number": "309-624-8820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 NE GLEN OAK AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616370001",
"telephone_number": "309-624-8820",
"fax_number": "309-624-8820"
}
],
"practiceLocations": [
{
"address_1": "10400 75th St",
"address_purpose": "LOCATION",
"city": "Kenosha",
"state": "WI",
"postal_code": "531427884",
"country_code": "US",
"telephone_number": "262-948-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10400 75th St",
"address_purpose": "LOCATION",
"city": "Kenosha",
"state": "WI",
"postal_code": "531427884",
"country_code": "US",
"telephone_number": "262-948-7000",
"fax_number": "414-385-4436",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2514 S 102nd St Ste 160",
"address_purpose": "LOCATION",
"city": "West Allis",
"state": "WI",
"postal_code": "532272142",
"country_code": "US",
"telephone_number": "414-255-0300",
"fax_number": "414-543-9601",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAMERON",
"first_name": "DORTHIA",
"middle_name": "D",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-09",
"last_updated": "2025-07-28",
"certification_date": "2025-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "6647",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "IL",
"license": "209030955",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100054093",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dwilson102724@aurora.direct-ci.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "10400 75th St",
"city": "Kenosha",
"state": "WI",
"country_code": "US",
"postal_code": "531427884",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "10400 75th St",
"city": "Kenosha",
"state": "WI",
"country_code": "US",
"postal_code": "531427884",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.
- 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.