Madison Broadwell, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5018127 Issued in NC

Practice address

195 W Illinois Ave
Southern Pines, NC 28387-5808

Phone

(910) 692-2444

NPI assigned

May 22, 2023

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sandhills Pediatrics

  • Pediatrics Physician
  • Southern Pines, NC
  • NPI 1114998150
  NPD (past)

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1295427052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 W ILLINOIS AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875808",
            "telephone_number": "910-692-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 W ILLINOIS AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875808",
            "telephone_number": "910-692-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWELL",
        "first_name": "MADISON",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5018127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Brinkley
• Jacqueline Brion Montalvo
• Natalie Britland
• Nina Diane Britt, COTA
• Sondra Britt, PTA
• Jeremy Dustin Brock, DMD
• Melissa Kaitlin Bronson, LCMHC ASSOCIATE
• Debbie Kathleen Brown, LMFT
• Lamesha Brown
• Taylor Brozovic

• Psychiatric/Mental Health Nurse Practitioner in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.