Kathleen Anne Broderick-Forsgren, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35 125546 Issued in OH

Practice address

234 Goodman St
Cincinnati, OH 45219-2364

Phone

(513) 584-7545

NPI assigned

Apr 5, 2012

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

Other names 1

• Kathleen Anne Broderick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1083970826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 CELESTIAL ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-584-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK-FORSGREN",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35 125546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "BRODERICK",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Brockman
• Alexis Brockmann
• David M Brodbeck, PA-C
• Matthew Brodbeck
• Steven S Brodbeck, LMT
• Erin Broderick
• George Steven Broderick, D.O.
• Joseph Broderick, MD
• Kara Lee Broderick
• Matthew Cullen Broderick, M.D.

• Internal Medicine Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.