ANDREA BROADNAX (NPI# 1508225160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508225160 |
| Entity Type | Individual |
| Full Name | ANDREA BROADNAX |
| Practice Address |
3444 Bragg Blvd Fayetteville NC 28303-3946 |
| Mailing Address |
882 Southview Cir Fayetteville NC 28311-0318 |
| Practice Telephone | 9102867873 |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2016-11-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 347C00000X | Private Vehicle | NC | Transportation Services | |
| N | 251S00000X | Community/Behavioral Health | 2016-3437-01 | NC | Agencies |
| Street Address |
3444 BRAGG BLVD |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-3946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235676248 | A Broader Future, Inc | Voluntary or Charitable | 3444 Bragg Blvd, Fayetteville, NC 28303-3946 | 2017-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 347C00000X |
| Grouping | Transportation Services |
| Classification | Private Vehicle |
| An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326507096 | Senior Transportationl.l.c. | Private Vehicle | 164 Tallstone Dr, Fayetteville, NC 28311 | 2019-03-13 |
| 1619435260 | Sandra Smith | Private Vehicle | 6074 Charles Ave, Fayetteville, NC 28311-1286 | 2019-03-03 |
| 1063947547 | Mediassist LLC | Private Vehicle | 1450 Steeple Run Dr, Fayetteville, NC 28312-9106 | 2017-04-21 |
| 1629522354 | Tst2 Corporation | Private Vehicle | 2309 Emily St, Fayetteville, NC 28301-3531 | 2016-08-10 |
| 1225491707 | Leslie's Staffing & Rehabilitation Services | Private Vehicle | 160 Bastille Way, Fayetteville, GA 30214-7653 | 2016-04-01 |
| 1962848606 | Jerry Christopher Towns | Private Vehicle | 113 Antique Ct, Fayetteville, NC 28312-9351 | 2013-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427664978 | Randy Tinsley | Private Vehicle | 4140 Hickory Blvd, Granite Falls, NC 28630-8371 | 2020-09-21 |
| 1821600016 | Covington Cares Patient Transport, LLC | Private Vehicle | 269 Moonstone Ct, Gibsonville, NC 27249-2969 | 2020-08-19 |
| 1740898121 | Cpw Transportation, LLC | Private Vehicle | 2456 Sunfield Dr, Graham, NC 27253-9801 | 2020-07-21 |
| 1700429966 | Allied Transportation LLC | Private Vehicle | 2400 New Hope Church Rd, Raleigh, NC 27604-2612 | 2019-10-21 |
| 1033761804 | Takisha Brown Mccollum | Private Vehicle | 806 S Martin Luther King Jr St, Rowland, NC 28383-9805 | 2019-07-11 |
| 1497313225 | Mona Rochelle Crawford | Private Vehicle | 1209 Larchmont Dr # 1209, Greensboro, NC 27405-6209 | 2019-06-05 |
| 1225596059 | Allen Affordable and Reliable Non-emergency Transportation, LLC | Private Vehicle | 1218 Dogwood Ln, Salisbury, NC 28146-6017 | 2019-03-11 |
| 1295291383 | Solace Biz, Inc | Private Vehicle | 802 Cox Ave, Thomasville, NC 27360-2943 | 2019-02-14 |
| 1053880351 | City To City Delivery, LLC | Private Vehicle | 1520 Atria Cir Apt 1214, Raleigh, NC 27604-5321 | 2018-11-15 |
| 1457835316 | A Rose A Day Foundation | Private Vehicle | 105 Snow Crest Trl, Durham, NC 27707-6102 | 2018-09-18 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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| 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.