Shannon Dee Broadie

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R0085845 Issued in OK

Practice address

721 E Grand Ave
Ponca City, OK 74601-5513

Phone

(580) 749-5139

NPI assigned

Jan 28, 2008

Last updated

Mar 4, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shannon Dee Cameron-Broadie Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1285811737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 E GRAND AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746015513",
            "telephone_number": "580-749-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 E GRAND AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746015513",
            "telephone_number": "580-749-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADIE",
        "first_name": "SHANNON",
        "middle_name": "DEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0085845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "CAMERON-BROADIE",
            "middle_name": "DEE",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Janice Kay Brewer-Bell, LPC
• Bridgeway
• Bridgeway, Inc.
• Noelle Brien
• Michael Thomas Bristow, MS,CCC-SLP
• Kristin M. Brock, LCSW
• Brown & Brown, D.D.S. (Hal W. Brown)
• Beverly F. Brown, L.P.N.
• Carol Ann Brown
• Cherish Brown

• Registered Nurse in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.