DANIEL JOHN BRODERICK (NPI# 1366635518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366635518 |
| Entity Type | Individual |
| Full Name | DANIEL JOHN BRODERICK |
| Credential | PHD |
| Practice Address |
5 Chalamont Ct Little Rock AR 72223-5511 |
| Practice Telephone | 7658081687 |
| Mailing Telephone | 7658081687 |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2015-11-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
20041132A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200532030A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487141990 | Daniel J Broderick | Student in an Organized Health Care Education/Training Program | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2018-04-19 |
| 1699090480 | Daniel K Broderick | Anesthesiology | 303 Parkway Dr Ne, Atlanta, GA 30312 | 2010-04-05 |
| 1659362739 | Daniel Broderick | Radiology | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-10-29 |
| Street Address |
5 CHALAMONT CT |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72223-5511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102242 | Tyler Edward Hicks | Chiropractor | 14300 West Cantrell Rd Suite 10, Little Rock, AR 72223 | 2019-03-08 |
| 1396268090 | Dawn Bridges | Day Training/Habilitation Specialist | 3920 Woodland Heights Road, Little Rock, AR 72223 | 2017-07-25 |
| 1235666983 | Grant Dennis | Chiropractor | 8201 Ranch Blvd., Suite B5, Little Rock, AR 72223 | 2017-05-12 |
| 1730581588 | Axpm-wlr, LLC | Dentist | 16003 Chanel Parkway, Little Rock, AR 72223 | 2014-09-24 |
| 1730421454 | Artineli Foot Care Solutions Pllc | Clinic/Center | 801 Technology Drive, Suite D, Little Rock, AR 72223 | 2013-03-20 |
| 1669758801 | William Patton Phillips | Obstetrics & Gynecology | 19 Bishop Place, Little Rock, AR 72223 | 2011-11-02 |
| 1003112160 | All Children's Therapy, Inc | Speech-Language Pathologist | 12410 Cantrell Rd., Suite 200, Little Rock, AR 72223 | 2011-02-07 |
| 1558697227 | Malcbndr581, LLC | Skilled Nursing Facility | 6411 Valley Ranch Dr, Little Rock, AR 72223 | 2009-10-30 |
| 1356578298 | Miranda White | Social Worker | 10 Pennsylvania Ct, Little Rock, AR 72223 | 2009-06-18 |
| 1457596959 | Leslie Ann Parks | General Practice | 14524 Cantrell Rd Suite 160, Little Rock, AR 72223 | 2008-12-11 |
| Find all providers in zip 72223 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043630734 | The Sage Center for Trauma and Wellness, Pllc | Psychologist | 2725 Cantrell Rd Ste 105, Little Rock, AR 72202-2044 | 2014-04-21 |
| 1134468895 | Brian Anderson | Psychologist | 1100 N University Ave Ste 108, Little Rock, AR 72207-6356 | 2013-01-31 |
| 1427300532 | Joy R. Pemberton | Psychologist | 4301 W. Markham, #554, Psychiatric Research Institute, Uams, Little Rock, AR 72205 | 2012-10-12 |
| 1548577521 | Laura Jane Gambone Nobles | Psychologist | 2723 Foxcroft Rd Ste 202a, Little Rock, AR 72227-6522 | 2010-09-11 |
| 1083858005 | George K. Simon Jr. | Psychologist | 1 Innwood Cir Ste 124, Little Rock, AR 72211-2448 | 2009-04-21 |
| 1730356825 | Tisha Lee Deen | Psychologist | 2723 Foxcroft Rd Ste 202, Little Rock, AR 72227-6522 | 2008-05-08 |
| 1205000403 | Meagan Rae Mcpherson | Psychologist | 10515 W Markham St Ste E3, Little Rock, AR 72205-2139 | 2008-04-17 |
| 1881894806 | Tracie L. Pasold | Psychologist | 800 Marshall St # 512-9, Dept. of Pediatrics, Section of Adolescent Medicine, Little Rock, AR 72202-3510 | 2007-07-18 |
| 1306976477 | Clinical Psychology Services, Inc. | Psychologist | 18 Corporate Hill Dr Ste 205, Little Rock, AR 72205-4541 | 2007-03-06 |
| 1861540015 | Rachel J Morrisey | Psychologist | 2200 Fort Roots Drive (116b/nlr), Central Arkansas Veterans Healthcare System, Little Rock, AR 72114 | 2007-01-06 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72223 |
Please comment or provide details below to improve the information on DANIEL JOHN BRODERICK.
| 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.