Broad Health of NC PC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

BROAD HEALTH OF NC PC

Practice address

2626 Glenwood Ave Ste 550
Raleigh, NC 27608-1370

Phone

(706) 455-2406

NPI assigned

May 2, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Mildred Santorufo, DO

Title

Owner

Phone

(706) 455-2406

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1043955396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 W 16TH ST # 6-110",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116201",
            "telephone_number": "617-513-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 GLENWOOD AVE STE 550",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276081370",
            "telephone_number": "706-455-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD HEALTH OF NC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "SANTORUFO",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-455-2406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Britt, ARNP
• Taylor Ann Britt, LCSWA
• Brittany Guerin, PLLC
• Britthaven, Inc.
• Ethan Brittingham, PT, DPT
• Walia Broadie
• Sheryl Schuck Broadright, P.T., C/NDT
• Broadstep Academy-Indiana Inc
• Broadway Home Care LLC
• Katherine Broadway, LPC

• All providers in Raleigh, NC
• Adult Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.