Camille Deanna Greider, MSN,RN,FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209024272 Issued in IL

Practice address

1003 E McCord St
Centralia, IL 62801-3345

Phone

(618) 436-8000

NPI assigned

Oct 30, 2019

Last updated

Dec 3, 2021By the provider in NPPES

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 IL

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Belleville Urgent Care Walk-in ClinicGroup PAC ID 4183050362, 5 clinicians

Physician Services Corporation of Southern Illinois IncGroup PAC ID 9234022567, 120 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cgreider407991@direct-ehr-ssmhc.com

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.

• Physician Services Corporation of Southern Illinois Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment Care Compare group NPD
• Belleville Urgent Care Walk-in Clinic

  • Family Medicine Physician
  • Belleville, IL
  • NPI 1225694946
  Medicare reassignment Care Compare group
• Alton Urgent Care Walk in Clinic Company

  • Family Medicine Physician
  • Alton, IL
  • NPI 1013521343
  Medicare reassignment
• Granite City Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Granite City, IL
  • NPI 1659861953
  Medicare reassignment
• Waterloo Urgent Care Walk in Clinic Company

  • Family Medicine Physician
  • Waterloo, IL
  • NPI 1508471418
  Medicare reassignment

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1699319004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6944 HOWARD SCHOOL RD",
            "city": "ASHLEY",
            "state": "IL",
            "postal_code": "628082406",
            "telephone_number": "573-999-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013345",
            "telephone_number": "618-436-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREIDER",
        "first_name": "CAMILLE",
        "middle_name": "DEANNA",
        "name_prefix": "Mrs.",
        "credential": "MSN,RN,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2021-12-03",
        "certification_date": "2021-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019056786",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Gesell
• Mary Gibson-McNutt
• Kimberly Going, P.T.
• Athena A Gordon, M.S.
• Grand Prairie CCSD 6
• Guardian Homes LLC
• Geeta Gupta, M.D.
• Narendra Kumar Gupta, M.D., F.A.C.S.
• Kathleen Gyore
• Bethany Hall

• Family Nurse Practitioner in Centralia, IL
• Providers in Centralia, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.