CAMRON L JOHNSON PRIVITERA (NPI# 1003810862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003810862 |
| Entity Type | Individual |
| Full Name | CAMRON L JOHNSON PRIVITERA |
| Credential | D.O. |
| Practice Address |
21 Highland Ave Se Ste 100 Roanoke VA 24013-2218 |
| Practice Telephone | 5403449213 |
| Practice Fax Number | 5403457559 |
| Mailing Telephone | 5403449213 |
| Mailing Fax Number | 5403457559 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 0102201592 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 139824 | 01 |
| VA | JOHN DEERE | 54088505618 | 01 |
| VA | AETNA | 7861556 | 01 |
| VA | SOUTHERN HEALTH | 244013 | 01 |
| VA | CIGNA | 6830577 | 01 |
| Street Address |
21 HIGHLAND AVE SE STE 100 |
| City | ROANOKE |
| State | VA |
| Zip Code | 24013-2218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003819574 | Robert C Gard | Pediatrics | 21 Highland Ave Se, Ste 100, Roanoke, VA 24013-2218 | 2005-05-27 |
| 1063752616 | Brittany Cook Kane | Obstetrics & Gynecology | 21 Highland Ave Se, Roanoke, VA 24013-2201 | 2013-02-19 |
| 1013261064 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 21 Highland Ave Se, Suite 200, Roanoke, VA 24013-2201 | 2012-10-30 |
| 1265701999 | Mary Jane Witter | Pediatrics | 21 Highland Ave Se, Suite 100, Roanoke, VA 24013-2201 | 2011-12-27 |
| 1528201506 | Margaret Ann Grove | Obstetrics & Gynecology | 21 Highland Ave Se, Suite 200, Roanoke, VA 24013-2201 | 2009-04-07 |
| 1467620773 | Roanoke Breast Care, Inc | Radiology | 21 Highland Ave Se, Ste 200, Roanoke, VA 24013-2201 | 2008-02-20 |
| 1558540062 | Jamie L Buck | Obstetrics & Gynecology | 21 Highland Ave Se, Suite 200, Roanoke, VA 24013-2201 | 2007-10-31 |
| 1750412060 | Daphne Elizabeth Damen | Nurse Practitioner | 21 Highland Ave Se, Suite 100, Roanoke, VA 24013-2201 | 2007-03-08 |
| 1598827263 | Melissa Parcher Perler | Midwife | 21 Highland Ave Se, Suite 200, Roanoke, VA 24013-2201 | 2006-12-15 |
| 1679651715 | Physicians To Women, Inc. | Obstetrics & Gynecology | 21 Highland Ave Se, Suite 200, Roanoke, VA 24013-2201 | 2006-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114091485 | Amy Barker | Registered Nurse | 102 Highland Ave Se Ste 203, Roanoke, VA 24013 | 2006-11-20 |
| 1992888432 | Valley Home Health Care LLC | Durable Medical Equipment & Medical Supplies | 1212 Campbell Ave Se, Roanoke, VA 24013 | 2006-10-20 |
| 1245325786 | Travis Pg Barham | Dentist | 101 Elm Ave, Roanoke, VA 24013 | 2006-10-03 |
| 1801251806 | Emily Lawson Bennett | Nurse Practitioner | 101 Elm Ave Se, Roanoke, VA 24013 | 2015-12-18 |
| 1629455936 | Mebratu Daba | Pediatrics | 102 Highland Ave Se Ste 104, Roanoke, VA 24013 | 2015-05-06 |
| 1720475296 | Hussein Elmufti | Pediatrics | 102 Highland Ave Se Ste 455, Roanoke, VA 24013 | 2015-04-22 |
| 1861467847 | Kilian H. Brech II | Pediatrics | 21 Highland Ave Se Ste 100, Roanoke, VA 24013 | 2006-02-22 |
| 1114545928 | Raven Matthews | Emergency Medicine | 213 18th St Se, Roanoke, VA 24013-1311 | 2020-07-08 |
| 1356557102 | Sandra Elaine Sayre | Nurse Practitioner | 402 4th St Se, Roanoke, VA 24013-1404 | 2007-05-15 |
| 1982041000 | Family Preservation Services, Inc. | Community/Behavioral Health | 825 Stewart Ave Se, Roanoke, VA 24013-1443 | 2013-05-30 |
| Find all providers in zip 24013 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407302847 | Elia Boles | Pediatrics | Carilion Clinic Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2016-08-26 |
| 1366715070 | Paul Elwood Bowles | Pediatrics | 5508 Village Drive, Roanoke, VA 24018-8773 | 2012-02-13 |
| 1881867646 | Silvia Natalia Jaimes Ocazionez | Pediatrics | 1030 S Jefferson St Ste 106, Roanoke, VA 24016-4418 | 2008-04-11 |
| 1508078635 | Nadia Gaafar Gard | Pediatrics | 4910 Valley View Blvd N W, Suite 310, Roanoke, VA 24012 | 2007-05-03 |
| 1497711345 | Theresa Ann Mutzig-erwin | Pediatrics | 516 E Byron Nelson Blvd, Roanoke, TX 76262-6295 | 2006-04-20 |
| 1922071869 | Arthur Kunkle | Pediatrics | 89 Summers Way, Roanoke, VA 24019-8291 | 2006-02-10 |
| 1942272273 | Mandy Atkinson | Pediatrics | 1906 Belleview Ave, Roanoke, VA 24014 | 2006-02-02 |
| 1548241086 | Maria R Soriano | Pediatrics | 1215 3rd St Sw, Roanoke, VA 24016-4611 | 2005-11-10 |
| 1700877404 | Floyd Randell Burton | Pediatrics | 21 Highland Ave Se Ste 100, Roanoke, VA 24013-2218 | 2005-11-02 |
| 1508864638 | Alise Magnuson | Pediatrics | 4615 Huntridge Rd, Roanoke, VA 24012-8510 | 2005-07-12 |
| Find all providers in ROANOKE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.