Active NPI
Leah Ruth Broadhurst, MD
- Internal Medicine Physician
- Hickory, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2021-02450
- Practice address
- 133 1St Ave SE
Hickory, NC 28602-3005 - Phone
- (828) 994-4544
- NPI assigned
- May 30, 2017
- Last updated
- Aug 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2021-02450 | NC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gaston Family Health Services, Inc. | Current | Accepting new patients | |
| Gaston Family Health Services, Inc | Current | 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
- 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.
-
dba Kintegra Family Medicine - Hudson
- Federally Qualified Health Center (FQHC)
- Gastonia, NC
- NPI 1215932215
-
dba Kintegra Family Medicine - Xray Dr
- Federally Qualified Health Center (FQHC)
- Gastonia, NC
- NPI 1306644315
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hickory, NC
- NPI 1164495255
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.