Individual provider Active NPI

Andrea Campbell, MSN, FNP-C

  • Family Nurse Practitioner
  • Novi, MI
National Provider Identifier
1679075758
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
470730069 Issued in MI
Practice address
44000 W 12 Mile Rd Ste 113
Novi, MI 48377
Phone
(248) 564-9253
NPI assigned
Mar 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 470730069 MI Primary

Addresses

Primary practice location

44000 W 12 Mile Rd Ste 113
Novi, MI 48377

Mailing address

44000 W 12 Mile Rd Ste 113
Novi, MI 48377-2647
Phone (248) 564-9253

Other practice location 1

44199 Dequindre Rd Ste 618
Troy, MI 48085-1128
Phone (248) 964-3928

Other names 1

  • Andrea Diemert Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address acampbell6592770@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180314002519 MI Practitioner - Nurse Practitioner 9931461761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

44199 Dequindre Rd
Troy, MI 48085-1128

Hospital & facility affiliations

  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
470730069MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Apr 4, 2024 Accepting new patients
William Beaumont Hospital Past Accepting new patients
John Haapaniemi& Barry Lesser PTR,Haapaniemi Lesser Associated PastSince Mar 1, 2018 Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

44199 Dequindre Rd
Ste 618
Troy, MI 48085
Phone (248) 879-2154

Interoperability endpoints

  • Direct secure messaging: acampbell2110474@epic00.corewelldirect.org

Organizations & group practices 3

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 4

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": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1679075758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44000 W 12 MILE RD STE 113",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772647",
            "telephone_number": "248-564-9253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44000 W 12 MILE RD STE 113",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48377",
            "telephone_number": "248-564-9253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44199 Dequindre Rd Ste 618",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851128",
            "country_code": "US",
            "telephone_number": "248-964-3928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ANDREA",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "470730069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acampbell6592770@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44199 Dequindre Rd Ste 618",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "DIEMERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.