Collene Wright Camill, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

52957 Issued in CA

Practice address

8220 Wynmark Dr
Ste 200
Elk Grove, CA 95757-6298

Phone

(916) 667-0600

Fax

(916) 683-0232

NPI assigned

Oct 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, VA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Dignity Health Medical Foundation

  dba Mercy Medical Group, a service of Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Inova Ucc LLC

  • Urgent Care Clinic/Center
  • Vienna, VA
  • NPI 1508592114
  Medicare reassignment
• Roanoke Valley Healthcare Partners, LLC

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1619274446
  Medicare reassignment
• Dignity Health Medical Foundation

  dba Dignity Health Medical Group - Sierra Nevada, a service of Dignity Hea

  • Multi-Specialty Clinic/Center
  • Grass Valley, CA
  • NPI 1043456106
  NPD
• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  NPD (past)
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Rancho Cordova, CA
  • NPI 1568489268
  NPD (past)
• Blue Ridge Healthcare Partners, LLC

  • Primary Care Clinic/Center
  • Roanoke, VA
  • NPI 1518304955
  NPD (past)

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1689045064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 WYNMARK DR",
            "address_2": "STE 200",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957576298",
            "telephone_number": "916-667-0600",
            "fax_number": "916-683-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMILL",
        "first_name": "COLLENE",
        "middle_name": "WRIGHT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008445",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Ali Callejas
• Maria T Cam
• Stefenee Dionne Camareno-Clinton, MSW
• Camelot Senior Living, Inc. (Camelot Care Home 2)
• Camelot Senior Living, Inc. (Camelot Care Home 3)
• Alissa J Camilo Lopes
• Jade Camp-Villalovos
• Audrey Campbell
• Jennifer Campbell
• Victoria Campbell

• Physician Assistant in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.

Verify at the official NPI Registry.