Individual provider Active NPI

Mary Worlds Broadwell, PT

  • Physical Therapist
  • Clayton, NC
National Provider Identifier
1336224690
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P1584 Issued in NC
Practice address
400 Guy Rd
Clayton, NC 27520-7205
Phone
(919) 553-8185
Fax
(919) 553-0187
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P1584 NC Primary

Addresses

Primary practice location

400 Guy Rd
Clayton, NC 27520-7205

Mailing address

400 Guy Rd
Clayton, NC 27520-7205
Phone (919) 553-8185

Other identifiers 2

IdentifierTypeStateIssuer
07762OtherNCBCBS PROVIDER NUMBER
7207762/7200094MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110110000640 NC Practitioner - Physical Therapist in Private Practice 7719959444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Guy Rd
Clayton, NC 27520-7205
Phone (919) 553-8185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P1584NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthos Physical Therapy Inc. Physical Therapist CurrentSince Mar 4, 1991 Accepting new patients

Locations

400 Guy Rd
Clayton, NC 27520
Phone (919) 553-8185

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1336224690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GUY RD",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275207205",
            "telephone_number": "919-553-8185",
            "fax_number": "919-553-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GUY RD",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275207205",
            "telephone_number": "919-553-8185",
            "fax_number": "919-553-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWELL",
        "first_name": "MARY",
        "middle_name": "WORLDS",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P1584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "07762",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7207762/7200094",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.