Cameron Dortch, MPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7800191-1206 Issued in UT

Practice address

1959 Aaron Dr # F
Tooele, UT 84074

Phone

(435) 843-1225

NPI assigned

Oct 15, 2010

Last updated

Oct 15, 2010By the provider in NPPES

Sex

Male

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

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Valley Family Medicine PC

  • Family Medicine Physician
  • Tooele, UT
  • NPI 1033412481
  Medicare reassignment

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1982914693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 WEST NAUTICAL DR",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "84074",
            "telephone_number": "801-787-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 AARON DR # F",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "84074",
            "telephone_number": "435-843-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORTCH",
        "first_name": "CAMERON",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7800191-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deseret Peak Anesthesia, LLC
• Desert Sky Mental Health Services
• Melissa Diaz
• Nikayla Dibble, NP
• Stephanie M Dickson, APRN-CRNA
• John Antoni Douglas, D.O.
• Suzette Dow
• Juliet Dowdle, MFT
• Sarah Rebecca Droubay, LMFT
• Eva Duarte, BHCM

• Physician Assistant in Tooele, UT
• Providers in Tooele, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.