Kelli Nicole Broadus, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN216907 Issued in GA

Practice address

1 Freedom Way
Augusta, GA 30904-6258

Phone

(706) 733-0188

NPI assigned

Apr 25, 2017

Last updated

Apr 25, 2017By 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 1

Addresses

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1306371661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 ROYAL OAK ST",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308133996",
            "telephone_number": "706-726-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADUS",
        "first_name": "KELLI",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN216907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy McCollough Brittingham, DMD
• Michael Andrew Brittingham, D.M.D.
• Eduardo E Britton, DDS
• Bryan Richard Broach, M.D.
• Gary Broadnax, MD
• Joseph Clayton Brock Jr., DO
• Hailey Brockman, FNP
• Jennifer Brodil, OD
• Marc Daniel Brody, PT
• Natalia Brody, MD

• Family Nurse Practitioner in Augusta, GA
• Providers in Augusta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.