Kristen L Broom, RN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R209609 Issued in MD

Practice address

6901 Security Blvd Ste 200
Windsor Mill, MD 21244-2412

Phone

(410) 837-2050

NPI assigned

Oct 14, 2005

Last updated

Jan 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chase Brexton Health Services IncGroup PAC ID 5395644835, shared by 6 NPIs, 119 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Chase Brexton Health Services, Inc.

  dba Chase Brexton Health Care

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1588606305
  Medicare reassignment NPD
• Chase Brexton Health Services, Inc.

  dba Chase Brexton Health Care

  • Federally Qualified Health Center (FQHC)
  • Columbia, MD
  • NPI 1376589309
  NPD
• Legacy Care Aco LLC

  • Family Medicine Physician
  • Virginia BCH, VA
  • NPI 1538844857
  NPD
• Rex Hospital, Inc.

  dba Rex Nutrition Services

  • Nutrition Education Nutritionist
  • Raleigh, NC
  • NPI 1821472572
  NPD (past)
• University of North Carolina at Chapel Hill

  dba UNC Faculty Physicians

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1073502969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015505",
            "telephone_number": "410-837-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 SECURITY BLVD STE 200",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442412",
            "telephone_number": "410-837-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOM",
        "first_name": "KRISTEN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R209609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Braham, NCC,LCPC
• Isabelle Braten
• Briteview Healthcare Solutions, LLC
• Broad Place, Inc
• Carson Keene Brooks
• Katrina Brown
• Martha Marie Brown
• Tammy Brown, LCSW-C
• Tyiesha Brown, D.P.T
• Valerie Lynne Brown

• Family Nurse Practitioner in Windsor Mill, MD
• Providers in Windsor Mill, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.

Verify at the official NPI Registry.