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JEREMY PHILLIPPE BROADNAX M.D. NPI 1326204611


NPI Information

NPI: 1326204611
Provider Name: JEREMY PHILLIPPE BROADNAX, M.D.
Classification: Anesthesiology - 207LP2900X
Entity Type: Individual

Specialization: Pain Medicine

PECOS Registration: Yes

Address:
1229 E SEMINOLE ST
STE 320
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 820-2064
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Jeremy Phillippe Broadnax, M.D. is a pain medicine anesthesiology in Springfield, MO with 16 years of experience. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. Jeremy Phillippe Broadnax, M.D. NPI is 1326204611. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduation Year:2008

The provider's business location address is:

1229 E SEMINOLE ST
STE 320
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 820-2064

The NPI 1326204611 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.

  • Injections of lower or sacral spine facet joint using imaging guidance (HCPCS:64493)
  • Injections of lower or sacral spine facet joint using imaging guidance (HCPCS:64494)
  • Injection of substance into spinal canal of lower back or sacrum using imaging guidance (HCPCS:62323)
  • Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • Injection procedure into sacroiliac joint for anesthetic or steroid (HCPCS:27096)
  • Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance (HCPCS:64483)
  • Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes (HCPCS:99152)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance (HCPCS:64635)

The enumeration date for this NPI number is 8/6/2008 and was last updated on 8/1/2019.


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
1207L00000XAnesthesiology2013031744MISSOURINo
2207LP2900XAnesthesiologyPain Medicine2013031744MISSOURIYes

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
1431560263OTHERMISSOURITRICARE
2200332001MEDICAIDARKANSAS
31326204611MEDICAIDMISSOURI
4P01246688OTHERMISSOURIRR MCR

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.