Broadway Medical Center

Primary specialty

SpecialistTaxonomy code 174400000X

License

590 Issued in MN

Legal business name

BROADWAY MEDICAL CENTER

Practice address

1527 Broadway St
Alexandria, MN 56308-2537

Phone

(320) 762-0399

Fax

(320) 762-6847

NPI assigned

Jan 30, 2006

Last updated

Feb 8, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charlene A Myren

Title

Assistant Administrator

Phone

(320) 762-6841

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott A Sundby, MD

  • Family Medicine Physician
  • Alexandria, MN
  • NPI 1376513770

  Specialist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1033180930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 BROADWAY ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082537",
            "telephone_number": "320-762-0399",
            "fax_number": "320-762-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 BROADWAY ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082537",
            "telephone_number": "320-762-0399",
            "fax_number": "320-762-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "MYREN",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "320-762-6841"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365838400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31T03BR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Breitzman, NP
• Melissa Kay Bright, RN
• Carrie K Brightman-Larson, BSW, LADC
• Ashley Mae Brimer, APRN, CNM
• Michael L Bristow, DO
• Brooke Evans, LLC (Redbird Counseling)
• Charles Brooks
• Rebecca L Brugger, MD
• Kayla Lynn Brunkow, PA-C
• Jenna Bryce, PHARMD

• Specialist in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.