Sandra Carol Broeren, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD157517 Issued in OR

Practice address

17055 Ruben LN
Sandy, OR 97055-9276

Phone

(503) 668-8002

Fax

(503) 668-5246

NPI assigned

Jun 7, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1285674499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17055 RUBEN LN",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970559276",
            "telephone_number": "503-668-8002",
            "fax_number": "503-668-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17055 RUBEN LN",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970559276",
            "telephone_number": "503-668-8002",
            "fax_number": "503-668-5246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 19th Street South",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "35233",
            "country_code": "US",
            "telephone_number": "205-934-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROEREN",
        "first_name": "SANDRA",
        "middle_name": "CAROL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD157517",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "26866",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933004",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051529785",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051529786",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933007",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051529784",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933006",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933008",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051529787",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Lewis Born, PSY.D.
• Hien Martine Bowden, NP
• Liisa Ann Bradshaw, FNTP
• Nicholas Christian Brechbiel
• Kayla Renae Briner, LMT
• Jamie Brown, PA-C
• Bruce a. Biermann D.M.D.,P.C.
• Madisen Bunch, RDH
• Sara A Buse, FNP
• Elizabeth Busetto, ND, DC, IBCLC

• Family Medicine Physician in Sandy, OR
• Providers in Sandy, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.