Broderick Nykaza

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-13783 Issued in NC

Practice address

2803 Medical Campus Dr. Seymour Johnson AFB
Goldsboro, NC 27531

Phone

(919) 722-1802

NPI assigned

Dec 9, 2022

Last updated

Jan 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1396456307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 MEDICAL CAMPUS DR. SEYMOUR JOHNSON AFB",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "27531",
            "telephone_number": "919-722-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 MEDICAL CAMPUS DR. SEYMOUR JOHNSON AFB",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "27531",
            "telephone_number": "919-722-1802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850042157",
            "country_code": "US",
            "telephone_number": "480-415-0561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYKAZA",
        "first_name": "BRODERICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-09",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13783",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leasa C Novotny, IDMT
• Glen A Nowachek, MD
• Roger Jerome Nunes, ED.D.
• Lesley Nunn, FNP
• Marie Harvin Nyberg, RD, LDN
• O.R. Stovall DDS
• O'Berry Neuro Medical Treatment Center
• O'Berry Neuro-Medical Treatment Center
• O'Berry Neuro-Medical Treatment Center
• Chrystie O'Neal, MS.PSY CADC-R

• Physician Assistant in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.