Stephen Matthew Brogdon, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

60788610 Issued in WA

Practice address

700 Lilly Rd NE
Olympia, WA 98506-5115

Phone

(360) 923-7700

Fax

(360) 923-7709

NPI assigned

Feb 25, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, FL, NY, GA4 enrollments

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 4

Specialty

Psychiatry

Education

Medical College of Georgia School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychiatric Professionals of Georgia, LLCGroup PAC ID 2567731482, 28 clinicians

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephen.brogdon@advantage.gadirect.net
• Direct secure messaging: sbrogdon844768@wm.providencedirect.org

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.

• Psychiatric Professionals of Georgia, LLC

  • Psychiatry Physician
  • Suwanee, GA
  • NPI 1396277968
  Medicare reassignment Care Compare group NPD
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• MCCD FL Psychiatry Services PA

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  WA

  Medicare reassignment NPD
• MCCD Psychiatry Services PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1033750823
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1124264577
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Geode Health Iop LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Suwanee, GA
  • NPI 1609766427
  NPD (past)

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1275702136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14611 SOLBERG RD SE",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985978541",
            "telephone_number": "504-559-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7700",
            "fax_number": "360-923-7709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 Barnes St",
            "address_purpose": "LOCATION",
            "city": "Bridge City",
            "state": "LA",
            "postal_code": "700943454",
            "country_code": "US",
            "telephone_number": "843-847-8582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROGDON",
        "first_name": "STEPHEN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-25",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "60788610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth J. Brock
• Jonathan D Brockman-Hawe
• Jennifer Brocx, LMT
• Genna Brodsky Chase, LICSW
• Janet Brodsky, LICSW
• Jodie E Broman, BA, CAAR, CDPT
• Mark Joseph Bronk, MARK BRONK, LMP
• Brookdale Senior Living Communities, Inc.
• Brooks Blessings Home Care LLC
• Dave Brooks, LMP

• Psychiatry Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.