Brooke Alice Borgeson-Gray, NP

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

License

4704124111 Issued in MI

Practice address

3147 Logan Valley Rd
Traverse City, MI 49684-4772

Phone

(231) 929-3111

Fax

(231) 946-0445

NPI assigned

Nov 8, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Honor Family Practice

  • Family Medicine Physician
  • Honor, MI
  • NPI 1760439541

  Community Health

  NPD (past)
• Honor Family Practice PLLC

  dba Honor Family Practice

  • Nurse Practitioner
  • Honor, MI
  • NPI 1396809760
  NPD (past)

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1447430236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3147 LOGAN VALLEY RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844772",
            "telephone_number": "231-929-3111",
            "fax_number": "231-946-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3147 LOGAN VALLEY RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844772",
            "telephone_number": "231-929-3111",
            "fax_number": "231-946-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGESON-GRAY",
        "first_name": "BROOKE",
        "middle_name": "ALICE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "MI",
            "license": "4704124111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447430236",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Boothroyd, PH.D.
• Katharene May Bopry
• Leah Borchardt, MA, LLPC
• Borealis Plastic Surgery, PLLC
• Thomas William Borgeld, PH.D.
• Amy Borgman, PH.D.
• Dawn Colleen Borgula, MSN, FNP-BC
• Matthew Born, PHARMD
• Edyta Marta Boron-Freseman
• Michael John Boros, MD

• Community Health Nurse Practitioner in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Community Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.