NPIMap

Individual provider Active NPI

Camille Elise Johnson, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Southfield, MI
National Provider Identifier
1558337147
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
4301061672 Issued in MI
Practice address
20905 Greenfield Rd Ste 600
Southfield, MI 48075-5355
Phone
(586) 646-2100
Fax
(586) 327-1441
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301061672 MI
Geriatric Medicine (Family Medicine) Physician 207QG0300X 4301061672 MI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 4301061672 MI Primary

Addresses

Primary practice location

20905 Greenfield Rd Ste 600
Southfield, MI 48075-5355

Mailing address

19785 W 12 Mile Rd # 591
Southfield, MI 48076-2584
Phone (586) 646-2100

Other identifiers 3

IdentifierTypeStateIssuer
4706904MedicaidMI
1108235612OtherMIBCN
1108235612OtherMIBC

Other names 1

  • Camille Elise Jones Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050330000843 MI Practitioner - Internal Medicine 7113973363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20905 Greenfield Rd
Suite 600M
Southfield, MI 48075-5355
Phone (586) 879-1921

Hospital & facility affiliations

  • Personalize Home Care Service Home health agency, Lathrup Village, MI, CCN 237674
  • Infinity Home Health Services Home health agency, Southfield, MI, CCN 239130
  • Ampower Home Health Care, LLC Home health agency, Clawson, MI, CCN 239351
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301061672MIMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wholistic Center for Restorative Health PLLC CurrentSince Jul 16, 2022 Accepting new patients
Healing Hands Family Health Center PLLC Internal Medicine CurrentSince Mar 31, 2005 Accepting new patients
Wholistic Center for Restorative Health and Functional Medicine PLLC Current Accepting new patients
Vandyke Medical Clinic Management Corp PastSince Sep 8, 2014 Accepting new patients
Gerald F Daneshvar MD PLLC Internal Medicine PastSince Jan 23, 2019 Accepting new patients

Locations

1538 Momentum Pl
Chicago, IL 60689

15301 E 8 Mile Rd
Eastpointe, MI 48021
Phone (586) 776-5677

20905 Greenfield Rd
Ste 600
Southfield, MI 48075
Phone (586) 646-2100

20905 Greenfield Rd
Ste 600M
Southfield, MI 48075
Phone (586) 646-2100

19785 W 12 Mile Rd
Southfield, MI 48076
Phone (313) 687-4455

Interoperability endpoints

  • Direct secure messaging: cjones@680403bc.micromddirect.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1558337147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19785 W 12 MILE RD # 591",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762584",
            "telephone_number": "586-646-2100",
            "fax_number": "586-327-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD STE 600",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755355",
            "telephone_number": "586-646-2100",
            "fax_number": "586-327-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAMILLE",
        "middle_name": "ELISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301061672",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301061672",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301061672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4706904",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "1108235612",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "1108235612",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLE",
            "last_name": "JONES",
            "middle_name": "ELISE",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.