Provider Type Icon

CARLA MARIE BRODERICK APRN NPI 1033115878


NPI Information

NPI: 1033115878
Provider Name: CARLA MARIE BRODERICK, APRN
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
2215 PORTLAND AVE
LOUISVILLE, KY
ZIP 40212
Phone: (502) 774-8631
Get Directions

Carla Marie Broderick, APRN is an adult health nurse practitioner in Louisville, KY with 26 years of experience. Carla Marie Broderick, APRN NPI is 1033115878. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2215 PORTLAND AVE
LOUISVILLE, KY
ZIP 40212
Phone: (502) 774-8631
Fax: (502) 996-8309

The NPI 1033115878 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Automated urinalysis test (HCPCS:81003)

The enumeration date for this NPI number is 6/27/2005 and was last updated on 1/25/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LA2200XNurse PractitionerAdult Health3002744KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000000200893OTHERKENTUCKYANTHEM
278009859MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.