Anthony Lee Broglio, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

010808 Issued in TN

Practice address

822 Broad St
Kingsport, TN 37660-3718

Phone

(423) 246-6251

Fax

(423) 246-7230

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bristol Urological Associates, P.C.

  • Urology Physician
  • Bristol, TN
  • NPI 1780764688
  NPD (past)
• Wellmont Medical Associates, Inc.

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1104878388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 BROAD ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603718",
            "telephone_number": "423-246-6251",
            "fax_number": "423-246-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 BROAD ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603718",
            "telephone_number": "423-246-6251",
            "fax_number": "423-246-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGLIO",
        "first_name": "ANTHONY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "010808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0213340004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "62086999803",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "043070",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007574258",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "2003575",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brighter Days
• Joshua Thomas Brintle, D.O.
• Bristol Orthotics & Prosthetics, Inc
• Jordan Broadwater, DDS
• Howard Thomas Brock, MD
• Brookhaven TN Opco LLC
• Chantel Ruth Brooks, DIPL. O.M. L.AC
• Haven Crawley Brooks, M.S., CCC-SLP
• Brookside Chiropractic, P. C.
• Brookside Vision Center

• Urology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Urology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.