NPI Details
DR. Samuel Lee Broffitt, M.D. is a family medicine in Covington, TN with 48 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Samuel Lee Broffitt, M.D. NPI is 1790882595. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
Education
Medical School: UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year:1978
The provider's business location address is:
1995 HIGHWAY 51 S
SUITE 202, NORTH DOCTORS BUILDING
COVINGTON, TN
ZIP 38019-635
Phone: (901) 476-4526
The NPI 1790882595 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 CLIA number assigned to this NPI record is 44D0313312 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
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.
- Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
- Injection of drug or substance under skin or into muscle (HCPCS:96372)
- Influenza vaccine, quadrivalent derived from cell cultures (HCPCS:90756)
- Administration of influenza virus vaccine (HCPCS:G0008)
- Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
- Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
The enumeration date for this NPI number is 9/20/2006 and was last updated on 7/8/2007.
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 Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207Q00000X | Family Medicine | | MD13148 | TENNESSEE | Yes |
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 Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 3185867 | MEDICAID | TENNESSEE | |
| 2 | 0016732 | OTHER | TENNESSEE | BLUE CROSS |
| 3 | B04213 | MEDICARE UPIN | | |
| 4 | 032147 | OTHER | | AMERICAN BRD. OF FAM. P. |
| 5 | 3185867 | MEDICARE ID-TYPE UNSPECIFIED | TENNESSEE | |
