Camille Wilson, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Columbus, Ohio. Her current practice location is
700 Children's Drive, Psychology Department, Columbus, Ohio. You can reach out to her office (for appointments etc.) via phone at
(614) 722-4700.
Camille Wilson is licensed to practice in Ohio (license number P.07903) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1942855754.
Healthcare Provider's Profile
| Full Name | Camille Wilson |
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| Gender | Female |
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| Speciality | Clinical Neuropsychologist |
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| Location | 700 Children's Drive, Columbus, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1942855754
- Provider Enumeration Date: 08/08/2019
- Last Update Date: 04/10/2025
Medicare PECOS Information:
- PECOS PAC ID: 4789084880
- Enrollment ID: I20210610003069
Medical Identifiers
Medical identifiers for Camille Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942855754 | NPI | - | NPPES |
| 0363329 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | P.07903 (Ohio) | Secondary |
| 103G00000X | Clinical Neuropsychologist | P.07903 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Camille Wilson allows following entities to bill medicare on her behalf.
| Entity Name | Pediatric Academic Association, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063419943
PECOS PAC ID: 2961306774
Enrollment ID: O20031124000198 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Camille Wilson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Camille Wilson, PHD
700 Children's Drive, Psychology Department,
Columbus, OH 43205
Ph: (614) 722-4700 | Camille Wilson, PHD
700 Children's Drive, Psychology Department,
Columbus, OH 43205
Ph: (614) 722-4700 |
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