Camille Coates-Clark, M.D. FAAOS.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

ME 86871 Issued in FL

Practice address

1601 SW Archer Road
Malcolm Randall NF/SG Veterans Health System
Gainesville, FL 32608

Phone

(352) 376-1611

NPI assigned

May 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1750599239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "address_2": "MALCOLM RANDALL NF/SG VETERANS HEALTH SYSTEM",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER ROAD",
            "address_2": "MALCOLM RANDALL NF/SG VETERANS HEALTH SYSTEM",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32608",
            "telephone_number": "352-376-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COATES-CLARK",
        "first_name": "CAMILLE",
        "name_prefix": "Dr.",
        "credential": "M.D. FAAOS.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME 86871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loretta M Coady-Fariborzian, MD
• Kyle Coady
• Austin Thomas Coale, MD
• Coast Florida P.a.
• Coast Florida P.a.
• Darren Coates, DPT
• Traci Coates
• Austin Lane Cobb
• Christine Cobb, RN, CNL
• Danielle McLaughlin Cobb, M.D.

• Sports Medicine (Orthopaedic Surgery) Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.