Michelle Marie Brodie, MS

Primary specialty

Neurology Physical TherapistTaxonomy code 2251N0400X

License

PT28069 Issued in CA

Practice address

4650 Palm Ave
San Diego, CA 92154-8404

Phone

(619) 662-5226

NPI assigned

Jun 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467659607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4237 HILLDALE RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162113",
            "telephone_number": "619-795-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 PALM AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921548404",
            "telephone_number": "619-662-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODIE",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CA",
            "license": "PT28069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Rose Broderick, FNP-BC
• Lori Broderick, M.D., PH.D.
• Ryan C Broderick, M.D
• James Sean Brodfuehrer, DDS
• Fred Joseph Brodie, DIVE IDC
• Kyle Brodmann, M.D.
• Mark E Brodsky, MD
• Rachel Brodsky
• Roxanne Brodsky
• Dora L Brody, IMF

• Neurology Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Neurology Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.