Sherri Broderick, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

15583 Issued in OR

Practice address

325 N Locust St
Sisters, OR 97759-5047

Phone

(541) 549-3534

NPI assigned

May 23, 2018

Last updated

May 23, 2018By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gregory Zadow Inc. P.S.

  dba Green Ridge Physical Therapy & Wellness

  • Physical Therapist
  • Sisters, OR
  • NPI 1407802101
  NPD (past)

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1043701279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 756",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977590756",
            "telephone_number": "541-241-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N LOCUST ST",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977595047",
            "telephone_number": "541-549-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "SHERRI",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "15583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Boyd
• Bradlley Allan Braman, DMD
• Elly Brand
• Laurel Marie Brauns, LPC-A
• Carol Joy Brendlinger
• Kathryn Brooks, ND, LAC.
• Kristin Cahill
• Madison Paige Cameron
• Chris Campbell, PT
• Gabrielle Louise Canavan, LMT

• Massage Therapist in Sisters, OR
• Providers in Sisters, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.