Camille Brazzle, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301506233 Issued in MI

Practice address

2205 Jolly Rd Ste B
Okemos, MI 48864-3983

Phone

(517) 347-4085

Fax

(855) 618-6655

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• CH MSSP Services Mi PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1609569169
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Portage, MI
  • NPI 1669091864
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Troy, MI
  • NPI 1336153295
  NPD
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD
• Dream Professional Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Bloomfield, MI
  • NPI 1417251943
  NPD (past)
• Kith Haven Acquisition Company, LLC

  • Skilled Nursing Facility
  • Flint, MI
  • NPI 1164429221
  NPD (past)
• Maple Psychiatric Associates, P.C.

  • Adolescent and Children Mental Health Clinic/Center
  • West Bloomfield, MI
  • NPI 1932382181
  NPD (past)
• Willowbrook Acquisition Company, LLC

  • Skilled Nursing Facility
  • Flint, MI
  • NPI 1437156437
  NPD (past)

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1194286484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639295 DEPT 93394",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639295",
            "telephone_number": "248-266-4200",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 JOLLY RD STE B",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643983",
            "telephone_number": "517-347-4085",
            "fax_number": "855-618-6655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24911 Little Mack Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480803200",
            "country_code": "US",
            "telephone_number": "586-777-2050",
            "fax_number": "586-777-2189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5640 W Maple Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223719",
            "country_code": "US",
            "telephone_number": "248-932-8585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAZZLE",
        "first_name": "CAMILLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301506233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denayjah Bradley
• Dominica J Bradley
• Branch Out Counseling Center
• Elizabeth A Brannick, PA
• Branson'S Couch Counseling, PLLC
• Tyler Breedlove
• Gerard Martin Breitzer, D.O.
• Elena Brennan
• Shelby Brennan
• Brian Carlin DDS PLC

• Family Medicine Physician in Okemos, MI
• Providers in Okemos, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.