Active NPI
Janan Broadbent, PH.D.
- Clinical Psychologist
- Baltimore, MD
National Provider Identifier
1023236114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1275
- Practice address
- 2 Hamill Rd
Suite 120
Baltimore, MD 21210-1837 - Phone
- (410) 825-5577
- Fax
- (410) 468-2555
- NPI assigned
- Apr 23, 2007
- Last updated
- Jun 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1275 | MD | Primary |
Addresses
Primary practice location
2 Hamill Rd
Suite 120
Baltimore, MD 21210-1837
Mailing address
2 Hamill Rd
Suite 120
Baltimore, MD 21210-1806
Phone (410) 825-5577
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G078J | Other | MD | CAREFIRSTBLUECROSSBLUESHI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110502000681 | MD | Practitioner - Clinical Psychologist | 9830374149 | Practice locations: Baltimore, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- University of California, Geffen School of Medicine, 1970
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
100 Harborview Dr
Baltimore, MD 21230-5404
Phone (410) 825-5577
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1275 | MD | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1023236114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 HAMILL RD",
"address_2": "SUITE 120",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212101806",
"telephone_number": "410-825-5577",
"fax_number": "410-468-2555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 HAMILL RD",
"address_2": "SUITE 120",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212101837",
"telephone_number": "410-825-5577",
"fax_number": "410-468-2555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADBENT",
"first_name": "JANAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "1275",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRSTBLUECROSSBLUESHI",
"identifier": "G078J",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.