Jesse Michael Broome, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101036999 Issued in VA

Practice address

840 First Colonial Rd
Suite 102B
Virginia Beach, VA 23451-6106

Phone

(757) 351-6226

Fax

(757) 351-6848

NPI assigned

Jan 23, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2013 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1043458441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 FIRST COLONIAL RD",
            "address_2": "SUITE 102B",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516106",
            "telephone_number": "757-351-6226",
            "fax_number": "757-351-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 FIRST COLONIAL RD",
            "address_2": "SUITE 102B",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516106",
            "telephone_number": "757-351-6226",
            "fax_number": "757-351-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "JESSE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-23",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101036999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shakirrah Monet Brooks, RBT
• Stephen Russell Brooks, NAVY IDC
• Valerie Brooks
• Brookside Psychiatric Specialists PLLC
• Mackenzie Ellen Broom
• Jasmine Brothers
• Tamara J Brothers, OD
• Steven Lee Broudy
• Allison Oliver Broughton, MA
• Virginia Lynn Broun, LPTA

• Internal Medicine Physician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.