Individual provider Active NPI

Laynette Goudy-Egger, N.P.

  • Adult Health Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1841282753
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704114991 Issued in MI
Practice address
29556 Southfield Rd
Suite 200
Southfield, MI 48076-2021
Phone
(248) 423-1550
Fax
(248) 423-1552
NPI assigned
Aug 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704114991 MI Primary

Addresses

Primary practice location

29556 Southfield Rd
Suite 200
Southfield, MI 48076-2021

Mailing address

2990 W Grand Blvd
Ste 307
Detroit, MI 48202-3081
Phone (248) 423-1550

Other identifiers 3

IdentifierTypeStateIssuer
P00218409OtherMIMEDICARE RAILROAD
4654399MedicaidMI
5008604330OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fine Touch Home Care Inc PastSince Sep 8, 2004 Accepting new patients
Seniors Wellness Group, P.C. Past Accepting new patients
Seniors Wellness Group of Michigan, P.C. Past Accepting new patients

Organizations & group practices 3

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1841282753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 W GRAND BLVD",
            "address_2": "STE 307",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023081",
            "telephone_number": "248-423-1550",
            "fax_number": "248-423-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29556 SOUTHFIELD RD",
            "address_2": "SUITE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762021",
            "telephone_number": "248-423-1550",
            "fax_number": "248-423-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDY-EGGER",
        "first_name": "LAYNETTE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704114991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00218409",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4654399",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5008604330",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.