BRYAN KENT BROADBENT (NPI# 1215011218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215011218 |
| Entity Type | Individual |
| Full Name | BRYAN KENT BROADBENT |
| Credential | DPM |
| Practice Address |
2300 E 30th St Bldg D-101 Farmington NM 87401-8991 |
| Practice Telephone | 5053271400 |
| Practice Fax Number | 5055643202 |
| Mailing Telephone | 5053271400 |
| Mailing Fax Number | 5055643202 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2019-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
POD.0000831 | CO | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
DP 00375 | OR | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
POD417 | NM | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 10432353 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 575 Rivergate Unit 105, Durango, CO 813017490 | 9702593154 | 9708281666 |
| 517 E Nizhoni Blvd, Gallup, NM 873015757 | 5053262255 | 8442701485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073553269 | Bryan Broadbent | Family Medicine | 7420 Market St, Wilmington, NC 28411-9453 | 2006-06-07 |
| Street Address |
2300 E 30TH ST BLDG D-101 |
| City | FARMINGTON |
| State | NM |
| Zip Code | 87401-8991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346798204 | Mathew Theron Southwick | Physician Assistant | 2300 E 30th St Bldg D-101, Farmington, NM 87401-8991 | 2016-09-20 |
| 1194955302 | Rena Nagl | Registered Nurse | 2300 E 30th St Bldg D-101, Farmington, NM 87401-8991 | 2009-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035192 | Jaylene Miller | Behavior Technician | 912 Fairgrounds Rd. Trl 36, Farmington, NM 87401 | 2020-08-28 |
| 1255940326 | John Andrew Martinez | Behavioral Analyst | 211 N Auburn, Farmington, NM 87401 | 2020-07-24 |
| 1598304990 | Chasitity Beulah Nez | Behavior Technician | 37 Rd 7101 #127, Farmington, NM 87401 | 2020-01-02 |
| 1205478575 | Micah Magee | Speech-Language Pathologist | Farmington High School, 2200 N. Sunset Ave, Farmington, NM 87401 | 2019-10-08 |
| 1831659754 | Lelilah Todacheene | Social Worker | 1204 Camina Real, Farmington, NM 87401 | 2019-03-25 |
| 1306323555 | Litany of Life | Counselor | 1010 Ridgeway Place, Farmington, NM 87401 | 2018-07-20 |
| 1093291213 | Brittany Bigham | Nurse Practitioner | 1001 W Broadway Ste E, Farmington, NM 87401 | 2018-07-11 |
| 1528556305 | Hairoun Home Health | Home Health | 1200 East 20th Street, Farmington, NM 87401 | 2018-04-26 |
| 1003338732 | Silver Tongue Speech & Voice, LLC | Clinic/Center | 3001 Northridge Dr Ste C, Farmington, NM 87401 | 2017-07-14 |
| 1902256621 | Capacity Builders Inc | Taxi | 418 W Broadway, Farmington, NM 87401 | 2016-06-14 |
| Find all providers in zip 87401 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093928673 | Samuel C. Carpenter, Dpmpc | Podiatrist | 4801 N Butler Ave, Suite 9102, Farmington, NM 87401-6002 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407026735 | Affiliated Podiatry Assoc. | Podiatrist | 539 Harkle Rd Ste C, Santa Fe, NM 87505-4783 | 2008-03-03 |
| 1174597397 | Susan Elizabeth Erredge | Podiatrist | Route 301 North 21 B Ave, Zuni, NM 87327-0467 | 2006-02-14 |
| 1295731628 | David R Sotelo | Podiatrist | 101 Hospital Loop Ne Ste 201, Albuquerque, NM 87109 | 2005-06-21 |
| 1679578520 | Michael Cohn | Podiatrist | 3804 Montgomery Blvd Ne, Albuquerque, NM 87109-1081 | 2005-06-16 |
| 1659688380 | Jla Senior Footcare Nm LLC | Podiatrist | 1600 W Ave I, Lovington, NM 88260-5002 | 2010-09-01 |
| 1083885388 | Dr Michael Cohn PC | Podiatrist | 3804 Montgomery Blvd Ne, Albuquerque, NM 87109-1081 | 2008-03-14 |
| 1760530893 | Jeffrey Michael Sauer | Podiatrist | 3917 West Rd, Ste 135, Los Alamos, NM 87544-2275 | 2007-01-08 |
| City | FARMINGTON |
| Zip Code | 87401 |
Please comment or provide details below to improve the information on BRYAN KENT BROADBENT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.