DR. CAMILLE NINA IMMANUEL (NPI# 1295021483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295021483 |
| Entity Type | Individual |
| Full Name | DR. CAMILLE NINA IMMANUEL |
| Credential | MD MHS |
| Practice Address |
4100 Cobscook Dr Durham NC 27707-5706 |
| Mailing Address |
42 Sycamore Rd Apt C Clifton NJ 07012-7330 |
| Practice Telephone | 2764514700 |
| Practice Fax Number | 2764514700 |
| Mailing Telephone | 2764514700 |
| Enumeration Date | 2011-06-26 |
| Last Update Date | 2018-02-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 39 | NJ | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
10549592-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | STUDENT & EDUCATION | #39 | 01 |
| Street Address |
4100 COBSCOOK DR |
| City | DURHAM |
| State | NC |
| Zip Code | 27707-5706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785928 | Ceara Smith | Social Worker | 1415 W Nc 54 Buidling 200, Suite 111, Durham, NC 27707 | 2020-06-22 |
| 1114554094 | Lauren Michelle Grosse | Physician Assistant | Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 | 2020-03-23 |
| 1386289635 | Ashley Bailey | Counselor | 1801 Fayetteville Street, Durham, NC 27707 | 2019-11-11 |
| 1881249886 | Erin Ramona Leger | Physical Therapist | 3706 Mayfair St, Ste 120, Durham, NC 27707 | 2019-08-06 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1477026144 | Pope Behavioral Health and Wellness | Counselor | 5102 Chapel Hill Durham Blvd., Suite 101, Durham, NC 27707 | 2019-01-06 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1780152827 | Cassandra Gerwig Shaw | Registered Nurse | 5324 Mcfarland Dr Ste 310, Durham, NC 27707 | 2018-11-07 |
| 1942776232 | Lisa J Keskitalo | Physical Therapist | 3708 Mayfair St Ste 120, Durham, NC 27707 | 2018-10-15 |
| Find all providers in zip 27707 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770663726 | Stephen Leinenweber | Pediatrics | Duke Hospital South Trent Dr, Durham, NC 27710-0001 | 2006-10-16 |
| 1417904889 | David A Turner | Pediatrics | 2300 Erwin Road, Durham, NC 27710 | 2006-05-30 |
| 1003159179 | Candice Marlow Ray | Pediatrics | 2301 Erwin Rd, Durham, NC 27710 | 2013-03-27 |
| 1215277876 | Rachael E Bushman | Pediatrics | 2100 Erwin Rd, Durham, NC 27705-3941 | 2013-02-19 |
| 1053602805 | Jennifer Irene Sherwin | Pediatrics | 2301 Erwin Rd, Durham, NC 27705 | 2011-04-27 |
| 1184882078 | Caroline Ozment | Pediatrics | 2100 Erwin Rd, Durham, NC 27705-3941 | 2008-05-28 |
| 1033272802 | Ira Cheifetz | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-12-19 |
| 1013070895 | Vinod Prasad | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-12-19 |
| 1710067715 | Jon Meliones | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-10-16 |
| 1154361491 | Rebecca L Smith | Pediatrics | 2100 Erwin Rd, Durham, NC 27705-3941 | 2006-06-07 |
| Find all providers in DURHAM | ||||
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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.