Individual provider Active NPI

Leah Ruth Broadhurst, MD

  • Internal Medicine Physician
  • Hickory, NC
National Provider Identifier
1437687993
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2021-02450 Issued in NC
Practice address
133 1St Ave SE
Hickory, NC 28602-3005
Phone
(828) 994-4544
NPI assigned
May 30, 2017
Last updated
Aug 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL41071 SC
Internal Medicine Physician 207R00000X 2021-02450 NC Primary
Pediatrics Physician 208000000X 2021-02450 NC

Addresses

Primary practice location

133 1St Ave SE
Hickory, NC 28602-3005

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210825001142 NC Practitioner - Internal Medicine 8123394715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

991 W Hudson Blvd
Gastonia, NC 28052-6430
Phone (704) 853-5079

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2021-02450NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Health Services, Inc. CurrentSince Aug 23, 2021 Accepting new patients
Gaston Family Health Services, Inc CurrentSince Aug 23, 2021 Accepting new patients

Locations

200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904

991 W Hudson Blvd
Gastonia, NC 28052
Phone (704) 853-5000

133 1st Ave SE
Hickory, NC 28602
Phone (828) 944-4544

Interoperability endpoints

  • Direct secure messaging: lbroadhurst353458@direct.ochin.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1437687993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 1ST AVE SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286023005",
            "telephone_number": "828-994-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADHURST",
        "first_name": "LEAH",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL41071",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2021-02450",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2021-02450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.