Active NPI
Steven Lee Broudy
- Pharmacist
- Virginia Beach, VA
National Provider Identifier
1275662769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202006588
- Practice address
- 5832 Midtowne Way
Support Center 1
Virginia Beach, VA 23464-5143 - Phone
- (757) 473-2737
- Fax
- (800) 359-5781
- NPI assigned
- Mar 2, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202006588 | VA | Primary |
Addresses
Primary practice location
5832 Midtowne Way
Support Center 1
Virginia Beach, VA 23464-5143
Mailing address
6907B Atlantic Ave
Virginia Beach, VA 23451-2022
Phone (757) 473-2737
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202006588 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275662769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6907B ATLANTIC AVE",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234512022",
"telephone_number": "757-473-2737",
"fax_number": "800-359-5781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5832 MIDTOWNE WAY",
"address_2": "SUPPORT CENTER 1",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234645143",
"telephone_number": "757-473-2737",
"fax_number": "800-359-5781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUDY",
"first_name": "STEVEN",
"middle_name": "LEE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202006588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.