Broadway Family Medicine Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BROADWAY FAMILY MEDICINE INC

Practice address

1470 N Broadway St
Suite100
Lebanon, OH 45036-1744

Phone

(513) 932-1936

Fax

(513) 932-3105

NPI assigned

Nov 18, 2005

Last updated

Sep 20, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rose Ebel, DONPI 1619950656

Title

President

Phone

(513) 932-1936

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2845/brand/1/csg/1/fhir/r4

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rose Ebel, DO

  • Family Medicine Physician
  • Lebanon, OH
  • NPI 1619950656
  Medicare reassignment Care Compare group NPD Authorized official
• Morgan Rowe, PA-C

  • Physician Assistant
  • Lebanon, OH
  • NPI 1851164792
  Medicare reassignment Care Compare group
• Sarah Wilson Christensen

  • Physician Assistant
  • San Antonio, TX
  • NPI 1497587752

  OH

  Medicare reassignment Care Compare group
• Katelyn Mokros, PA-C

  • Physician Assistant
  • Lebanon, OH
  • NPI 1104601780
  Medicare reassignment

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1083696538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4723",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154723",
            "telephone_number": "513-932-1936",
            "fax_number": "513-932-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 N BROADWAY ST",
            "address_2": "SUITE100",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450361744",
            "telephone_number": "513-932-1936",
            "fax_number": "513-932-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY FAMILY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "EBEL",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-932-1936",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "CK5993",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2378538",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Brandon, LPN
• James Breen
• Margaret Bremmer, LPCC
• Deann Kay Brewer, M.D.
• Cori Brittain, LMHC
• Theresa A Brockman, LISW
• Allison Rachel Broderick, M.A., CF-SLP
• Alyssa P Brown, CDCA
• Elizabeth Brown
• Monica Brown, CNP

• Family Medicine Physician in Lebanon, OH
• Providers in Lebanon, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.