Kimberly Suzanne Broderick, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1085785 Issued in TX

Practice address

7840 FM 1960 Rd E Ste 408409
Humble, TX 77346-2259

Phone

(281) 812-6665

Fax

(281) 812-6869

NPI assigned

Feb 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Caba Therapy Services

  • Physical Therapist
  • Baytown, TX
  • NPI 1548338528
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1134264187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8107 LEIGHWOOD CREEK CT",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773963477",
            "telephone_number": "281-458-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 FM 1960 RD E STE 408409",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773462259",
            "telephone_number": "281-812-6665",
            "fax_number": "281-812-6869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2802 Garth Rd",
            "address_2": "Suite 109",
            "address_purpose": "LOCATION",
            "city": "Baytown",
            "state": "TX",
            "postal_code": "775213900",
            "country_code": "US",
            "telephone_number": "832-556-7750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "KIMBERLY",
        "middle_name": "SUZANNE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1-8578-5",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1085785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Clark Bridges, OTR
• Bridging the Gap Counseling Services PLLC
• Micaela L Briggs
• Victoria Ashley Brinkley, APRN
• Paolo Briones, NP-C
• Dylan Elliot Brooks, MD
• George Alfred Brooks, MD PHD
• Laterria Brooks
• Mark Brooks, PA-C
• Cynthia Brothers, BCBA

• Physical Therapist in Humble, TX
• Providers in Humble, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; 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.