Individual provider Active NPI

Salvador Ramos Camacho, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Fayetteville, GA
National Provider Identifier
1861790552
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
069937 Issued in GA
Practice address
1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone
(770) 719-7000
NPI assigned
Mar 4, 2011
Last updated
Jul 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.016666 OH
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 069937 GA Primary

Addresses

Primary practice location

1255 Highway 54 W
Fayetteville, GA 30214-4526

Mailing address

702 Bostonian Trce
Peachtree City, GA 30269-5627

Other practice location 1

3495 Piedmont Rd NE
Atlanta, GA 30305-1717
Phone (404) 367-2528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130813000511 GA Practitioner - Internal Medicine 0042452534 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1255 Hwy 54 W
Fayetteville, GA 30214-4526
Phone (770) 719-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57.016666OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Internal Medicine CurrentSince Jul 30, 2018 Accepting new patients
Piedmont Specialty Hospital Billing LLC Internal Medicine CurrentSince Jul 7, 2021 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1861790552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 BOSTONIAN TRCE",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302695627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144526",
            "telephone_number": "770-719-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3495 Piedmont Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303051717",
            "country_code": "US",
            "telephone_number": "404-367-2528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMOS CAMACHO",
        "first_name": "SALVADOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-04",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.016666",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "069937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.