Active NPI
Amy Broom, M.A. CCC-A
- Otolaryngology Physician
- Carmel, IN
National Provider Identifier
1144464363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 23002442A
- Practice address
- 12188A N Meridian St Ste 375
Carmel, IN 46032-4433 - Phone
- (317) 926-1056
- Fax
- (317) 806-2323
- NPI assigned
- May 1, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 23002442A | IN | Primary |
Addresses
Primary practice location
12188A N Meridian St Ste 375
Carmel, IN 46032-4433
Mailing address
12188A N Meridian St Ste 375
Carmel, IN 46032-4433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23002442A | IN | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241136000000",
"number": "1144464363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12188A N MERIDIAN ST STE 375",
"city": "CARMEL",
"state": "IN",
"postal_code": "460324433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12188A N MERIDIAN ST STE 375",
"city": "CARMEL",
"state": "IN",
"postal_code": "460324433",
"telephone_number": "317-926-1056",
"fax_number": "317-806-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOM",
"first_name": "AMY",
"credential": "M.A. CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-01",
"last_updated": "2009-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IN",
"license": "23002442A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.