Individual provider Active NPI

Brandee Laine Obenauf, NP

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1154777258
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN243093 Issued in GA
Practice address
840 Pine St Ste 510
Macon, GA 31201-7530
Phone
(478) 633-8060
Fax
(478) 633-4080
NPI assigned
May 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN243093 GA Primary

Addresses

Primary practice location

840 Pine St Ste 510
Macon, GA 31201-7530

Mailing address

840 Pine St Ste 510
Macon, GA 31201-7530
Phone (478) 633-8060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160614001139 GA Practitioner - Nurse Practitioner 6406147941 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Central Georgia, Inc CurrentSince Apr 11, 2016 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

840 Pine St
Ste 510
Macon, GA 31201
Phone (478) 633-8383

840 Pine St
Ste 900
Macon, GA 31201
Phone (478) 633-8060

2490 Riverside Dr
Ste B
Macon, GA 31204
Phone (478) 633-6633

770 Pine St
Ste 140
Macon, GA 31201
Phone (478) 633-1821

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1154777258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 PINE ST STE 510",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017530",
            "telephone_number": "478-633-8060",
            "fax_number": "478-633-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 PINE ST STE 510",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017530",
            "telephone_number": "478-633-8060",
            "fax_number": "478-633-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENAUF",
        "first_name": "BRANDEE",
        "middle_name": "LAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN243093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.