Individual provider Active NPI

Camille Lee Andy, MD

  • Family Medicine Physician
  • Greensboro, NC
National Provider Identifier
1669420469
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9701220 Issued in NC
Practice address
4443 Jessup Grove Rd
Greensboro, NC 27410-9934
Phone
(336) 663-4600
NPI assigned
May 4, 2006
Last updated
Aug 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 64251 NC
Family Medicine Physician 207Q00000X 9701220 NC Primary

Addresses

Primary practice location

4443 Jessup Grove Rd
Greensboro, NC 27410-9934

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 996-2173

Other practice location 1

1941 New Garden Rd 216
Greensboro, NC 27410-2555
Phone (336) 288-8857

Other identifiers 5

IdentifierTypeStateIssuer
891160GMedicaidNC
28689OtherNCPARTNERS MEDICARE
5718773OtherNCAETNA
71483OtherNCMEDCOST
1160GOtherNCBCBSNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address candy461017@direct.conehealth.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071025000224 NC Practitioner - Family Practice 7416044391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moses Cone Medical Services IncGroup PAC ID 2769395458, 214 clinicians

Practice addresses (Care Compare)

520 N Elam Ave
Greensboro, NC 27403-1127
Phone (336) 547-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64251NCMDFamily Medicine Physician
9701120NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Medical Services, Inc. Family Medicine CurrentSince Nov 11, 2018 Accepting new patients
Moses Cone Medical Services, Inc. Family Medicine CurrentSince Nov 11, 2018 Accepting new patients
Laurel Creek Family Medicine, PLLC Family Medicine PastSince Jun 1, 2005 Accepting new patients
Cornerstone Health Care, PA Family Medicine Past Accepting new patients

Locations

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

4443 Jessup Grove Rd
Greensboro, NC 27410
Phone (336) 663-4600

520 N Elam Ave
Greensboro, NC 27403
Phone (336) 475-7148

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1669420469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-996-2173",
            "fax_number": "336-996-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4443 JESSUP GROVE RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109934",
            "telephone_number": "336-663-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1941 NEW GARDEN RD 216",
            "address_purpose": "LOCATION",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102555",
            "country_code": "US",
            "telephone_number": "336-288-8857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDY",
        "first_name": "CAMILLE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "64251",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9701220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891160G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE",
            "identifier": "28689",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5718773",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "71483",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "1160G",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "candy461017@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health DirectAddress",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4443 Jessup Grove Rd",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274109934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.