David Phillip Camacho, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1435 Issued in NE

Practice address

2300 W Capital Ave
Grand Island, NE 68803-2003

Phone

(308) 385-6252

NPI assigned

Jan 29, 2016

Last updated

Jan 29, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1780042283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 W 10TH ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688033611",
            "telephone_number": "308-268-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W CAPITAL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032003",
            "telephone_number": "308-385-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "DAVID",
        "middle_name": "PHILLIP",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NE",
            "license": "1435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dayana Calcines
• Jacqueline Jo Caldwell
• Ann Mechelle Calhoun
• Heather Mae Calkins, PHD, LP
• Alysianna Camacho
• Shelia Camargo
• Scott Cameron
• Wendy Cameron
• Jennifer Patricia Cammon-Larson, PLMHP
• Marion Campana Ekern

• Physical Therapy Assistant in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Physical Therapy Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.