Individual provider Active NPI

Ellen Brubeck Brogden, M.D.

  • Family Medicine Physician
  • Mount Olive, NC
National Provider Identifier
1184706830
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20911 Issued in NC
Practice address
1140 N Breazeale Ave
Mount Olive, NC 28365-1121
Phone
(919) 299-4800
Fax
(919) 299-4802
NPI assigned
Oct 20, 2006
Last updated
Feb 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20911 NC Primary

Addresses

Primary practice location

1140 N Breazeale Ave
Mount Olive, NC 28365-1121

Mailing address

1140 N Breazeale Ave
Mount Olive, NC 28365-1121
Phone (919) 299-4800

Other names 1

  • Mrs. Ellen Brubeck Brogden Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110112001025 NC Practitioner - Family PracticePractitioner - Geriatric Medicine 7416146089 Practice locations: Mount Olive, NC

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Ohio State University College of Medicine, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1140 N Breazeale Ave
Mount Olive, NC 28365-1121
Phone (919) 299-4800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20911NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cynthia Vail, PA-C, PA PastSince Nov 1, 2019 Accepting new patients

Organizations & group practices 1

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1184706830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 N BREAZEALE AVE",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283651121",
            "telephone_number": "919-299-4800",
            "fax_number": "919-299-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 N BREAZEALE AVE",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283651121",
            "telephone_number": "919-299-4800",
            "fax_number": "919-299-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGDEN",
        "first_name": "ELLEN",
        "middle_name": "BRUBECK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "20911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "BROGDEN",
            "middle_name": "BRUBECK",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mount Olive, NC

Sources for this page

Verify at the official NPI Registry.