Erin Broderick, D.O.
Individual provider Active NPI Emergency Medicine Physician · Lumberton, NC
NPI 1083001986 · NPPES record last updated Feb 14, 2018
Key facts
- NPI
- 1083001986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 209926 (NC)
- Practice address
- 300 West 27TH Street
Southeastern Health
Lumberton, NC 28359 - Phone
- (910) 272-1478
- Fax
- (910) 671-5392
- NPI assigned
- Apr 20, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cherokee Nation
Practice addresses (Care Compare)
100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100
Hospital & facility affiliations
- Cherokee Nation W W Hastings Indian Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.51 of 100
- Quality
- 84.87
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191007002535 | OK | Practitioner - Emergency Medicine | 8224321906 | Reassigns benefits to 1 organization |
| I20250211003980 | TX | Practitioner - Emergency Medicine | 8224321906 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6620 | OK | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherokee Nation | Current |
Accepting new patients | |
| Cherokee Nation | Current |
Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Emergency Medicine Physicians of Tulsa County, LLC | Emergency Medicine | Current |
Accepting new patients |
| Cherokee Nation | Current | Accepting new patients | |
| Saint Francis Hospital South LLC | Past | Accepting new patients | |
| Saint Francis Hospital, Inc. | Past | Accepting new patients | |
| Saint Francis Hospital Muskogee Inc | Past | Accepting new patients |
Locations
1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000
859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271
1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201
1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192
900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500
100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100
10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000
Dept 2269
Tulsa, OK 74182
27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 209926 | NC | Yes |
Addresses
Primary practice location
300 West 27TH Street
Southeastern Health
Lumberton, NC 28359
Mailing address
300 West 27TH Street
Southeastern Health
Lumberton, NC 28359
Phone (910) 272-1478
Other providers in Lumberton, NC
- Nancy Britt
- Samuel E Britt II
- Savannah Victoria Britt
- Stephanie Britt
- Britthaven, Inc.
- Dalton Peter Brooks III
- Dalton Peter Brooks Jr.
- Margaret Danielle Brooks
- Melissa Christine Brooks
- Nicala Noell Brooks
All providers in Lumberton, NC · Emergency Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.