Individual provider Active NPI

Andres Camilo Ruiz, MD

  • Neurocritical Care Physician
  • Gainesville, GA
National Provider Identifier
1740518695
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
92874 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 219-9000
NPI assigned
Dec 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care Physician 2084A2900X 2025-00249 NC
Neurology Physician 2084N0400X MD487794 PA
Neurology Physician 2084N0400X 2025-00249 NC
Neurocritical Care Physician 2084A2900X 82321 SC
Neurology Physician 2084N0400X 2017008829 MO
Neurocritical Care Physician 2084A2900X 92874 GA Primary
Neurocritical Care Physician 2084A2900X 2017008829 MO

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

228 Saint Charles Way Ste 200
York, PA 17402-4661
Phone (717) 851-5503

Other practice location 2

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-7594

Other practice location 3

200 Patewood Dr Ste B350
Greenville, SC 29615-6337
Phone (864) 454-4500

Other identifiers 1

IdentifierTypeStateIssuer
1740518695MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA, NC, PA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20190827000913 SC Practitioner - Neurology 0446491492 Reassigns benefits to 1 organization
I20220815000407 GA Practitioner - Neurology 0446491492 Reassigns benefits to 1 organization
I20250307003354 NC Practitioner - Neurology 0446491492 Reassigns benefits to 1 organization
I20260319002011 PA Practitioner - Neurology 0446491492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Mercer University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000

200 Patewood Dr
Suite B350
Greenville, SC 29615-6337
Phone (864) 454-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92874GAMDNeurocritical Care Physician
2025-00249NCMDNeurocritical Care Physician
82321SCMDNeurocritical Care Physician
MD487794PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Feb 6, 2025 Accepting new patients
Wellspan Medical Group CurrentSince Feb 7, 2026 Accepting new patients
Northeast Georgia Physicians Group Inc Neurology CurrentSince Aug 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Wellspan Medical Group CurrentSince Feb 7, 2026 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 5, 2019 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 5, 2019 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 6, 2025 Accepting new patients

Locations

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

228 Saint Charles Way
Ste 200
York, PA 17402

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Patewood Dr
Ste B350
Greenville, SC 29615
Phone (864) 454-4500

300 E McBee Ave
Ste 401
Greenville, SC 29601

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

Organizations & group practices 10

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 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1740518695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 Saint Charles Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174024661",
            "country_code": "US",
            "telephone_number": "717-851-5503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Silas Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "336-718-7594",
            "fax_number": "336-277-4239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Patewood Dr Ste B350",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296156337",
            "country_code": "US",
            "telephone_number": "864-454-4500",
            "fax_number": "864-454-4505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ANDRES",
        "middle_name": "CAMILO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-03",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "NC",
            "license": "2025-00249",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD487794",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2025-00249",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "SC",
            "license": "82321",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2017008829",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "GA",
            "license": "92874",
            "primary": true
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "MO",
            "license": "2017008829",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740518695",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.