David Leroy Camenga, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

31440 Issued in MN

Practice address

420 E Stark Rd
Milton, WI 53563-8300

Phone

(320) 630-3203

NPI assigned

Sep 27, 2007

Last updated

Sep 27, 2007By 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 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1841487345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E STARK RD",
            "city": "MILTON",
            "state": "WI",
            "postal_code": "535638300",
            "telephone_number": "320-630-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E STARK RD",
            "city": "MILTON",
            "state": "WI",
            "postal_code": "535638300",
            "telephone_number": "320-630-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMENGA",
        "first_name": "DAVID",
        "middle_name": "LEROY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "31440",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "31720-020",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME 93547",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287508000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38724800",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32753000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Ackerman
• Kathleen E Becker, BUSINESS OWNER
• Linda Bentz, CPM, LM
• David Charles Bitter, R.PH.
• Dominique Boston
• Gina F Carrola
• Katie Check
• Rachell Chesmore
• Bethany Anne Christon, M.S., CCC-SLP
• Mary Lu Clay, RN

• Neurology Physician in Milton, WI
• Providers in Milton, WI by specialty
• Neurology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; 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.