Active NPI
Barry Broadnax Jr.
- Student in an Organized Health Care Education/Training Program
- Washington, DC
National Provider Identifier
1336029776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 106 Irving St NW Ste 4200
Washington, DC 20010-2972 - Phone
- (202) 877-2200
- NPI assigned
- Sep 5, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
106 Irving St NW Ste 4200
Washington, DC 20010-2972
Mailing address
511 Gresham PL NW
Washington, DC 20059-1010
Phone (276) 806-5971
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757030400000",
"number": "1336029776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 GRESHAM PL NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200591010",
"telephone_number": "276-806-5971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 IRVING ST NW STE 4200",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102972",
"telephone_number": "202-877-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADNAX",
"first_name": "BARRY",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-05",
"last_updated": "2025-09-05",
"certification_date": "2025-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.