Active NPI
Brandy Godbout
- Family Nurse Practitioner
- Ortonville, MI
National Provider Identifier
1427844356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704311410
- Practice address
- 1368 Perry Lake Rd
Ortonville, MI 48462-9111 - Phone
- (586) 556-6020
- NPI assigned
- Apr 17, 2025
- Last updated
- Apr 17, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704311410 | MI | Primary |
Addresses
Primary practice location
1368 Perry Lake Rd
Ortonville, MI 48462-9111
Mailing address
1368 Perry Lake Rd
Ortonville, MI 48462-9111
Phone (586) 556-6020
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4055 Valley View LN
Suite 700
Dallas, TX 75244-4910
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704311410 | MI | MD | Family Nurse Practitioner |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744848000000",
"number": "1427844356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1368 PERRY LAKE RD",
"city": "ORTONVILLE",
"state": "MI",
"postal_code": "484629111",
"telephone_number": "586-556-6020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1368 PERRY LAKE RD",
"city": "ORTONVILLE",
"state": "MI",
"postal_code": "484629111",
"telephone_number": "586-556-6020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODBOUT",
"first_name": "BRANDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-17",
"last_updated": "2025-04-17",
"certification_date": "2025-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704311410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ortonville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.