Individual provider Active NPI

Christopher Cade Broderick, D.C

  • Chiropractor
  • Green Valley, AZ
National Provider Identifier
1467745711
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8231 Issued in AZ
Practice address
380 W Vista Hermosa Dr Ste 100
Green Valley, AZ 85614-1901
Phone
(520) 490-2610
NPI assigned
May 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8231 AZ Primary

Addresses

Primary practice location

380 W Vista Hermosa Dr Ste 100
Green Valley, AZ 85614-1901

Mailing address

380 W Vista Hermosa Dr Ste 100
Green Valley, AZ 85614-1901
Phone (520) 490-2610

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8231AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Green Valley Chiropractic Center Inc. Chiropractor CurrentSince Nov 28, 2017 Accepting new patients

Locations

380 W Vista Hermosa Dr
Ste 100
Green Valley, AZ 85614
Phone (520) 648-2225

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467745711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W VISTA HERMOSA DR STE 100",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856141901",
            "telephone_number": "520-490-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 W VISTA HERMOSA DR STE 100",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856141901",
            "telephone_number": "520-490-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "CHRISTOPHER",
        "middle_name": "CADE",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.