Active NPI
Dennis E. Broadbent, PH.D.
- Psychologist
- Phoenix, AZ
National Provider Identifier
1124209275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 903
- Practice address
- 2432 W. Peoria Avenue
Suite 1327
Phoenix, AZ 85029 - Phone
- (602) 866-3432
- Fax
- (602) 866-3764
- NPI assigned
- Nov 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 903 | AZ | Primary |
Addresses
Primary practice location
2432 W. Peoria Avenue
Suite 1327
Phoenix, AZ 85029
Mailing address
2432 W. Peoria Avenue
Suite 1327
Phoenix, AZ 85029
Phone (602) 866-3432
Medicare participation
Medicare enrollment files- 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: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1124209275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2432 W. PEORIA AVENUE",
"address_2": "SUITE 1327",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85029",
"telephone_number": "602-866-3432",
"fax_number": "602-866-3764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2432 W. PEORIA AVENUE",
"address_2": "SUITE 1327",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85029",
"telephone_number": "602-866-3432",
"fax_number": "602-866-3764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADBENT",
"first_name": "DENNIS",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-16",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.