Individual provider Active NPI

Danielle Broccoli, RN

  • High-Risk Obstetric Registered Nurse
  • Dallas, TX
National Provider Identifier
1437786910
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
High-Risk Obstetric Registered NurseTaxonomy code 163WX0002X
License
962107 Issued in TX
Practice address
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone
(908) 370-8735
NPI assigned
Mar 25, 2020
Last updated
Mar 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
High-Risk Obstetric Registered Nurse 163WX0002X 962107 TX Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Mailing address

483 Clear Creek LN
Coppell, TX 75019-3310

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
962107TXMDHigh-Risk Obstetric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1437786910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 CLEAR CREEK LN",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750193310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "908-370-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCCOLI",
        "first_name": "DANIELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, High-Risk",
            "state": "TX",
            "license": "962107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.