Tiffany Broadnax, CMA

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

2404435 Issued in NC

Practice address

1100 E Wendover Ave
Greensboro, NC 27405-6713

Phone

(336) 641-4592

NPI assigned

Jul 14, 2016

Sex

Female

Sole proprietor

Yes

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

Certified Medical Assistant

State licenses

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1528411642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 ASH ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272884829",
            "telephone_number": "336-589-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056713",
            "telephone_number": "336-641-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADNAX",
        "first_name": "TIFFANY",
        "credential": "CMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NC",
            "license": "2404435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britthaven, Inc.
• Britthaven, Inc.
• Candice Dawn Broadnax, MED CCC-SLP
• Shonda Broadnax
• Tia Lea Broadnax
• Christine Broadwater, L.P.C.
• Thomas E Brock, M.D.
• Taylor Kellen Broderick
• Bruce Rogers Brodie, M.D.
• Dora Miroslava Brodie, M.D.

• Community Health Worker in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Community Health Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.