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NPI Code Detail

MEDICARE: JAMIE MCCAMMON

MEDICARE: JAMIE MCCAMMON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-26-511689IL

General Provider Information

NPI Number : 1154274892
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE MCCAMMON
Provider Business Mailing Address
First Line : 1827 E IRELAND RD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46614-2845
Country : US
Telephone Number : 574-387-4313
Fax Number : 574-204-2868
Provider Business Practice Location Address
First Line : 1045 12TH AVE
Second Line :
City : EAST MOLINE
State : IL
Zip : 61244-1474
Country : US
Telephone Number : 574-387-4313
Fax Number : 574-204-2868
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2026
Last Update Date : 02/20/2026

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Directions to “ JAMIE MCCAMMON ” Practice Location

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