Julie Vang Broaddrick, FNP-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R0118511 Issued in OK

Practice address

11911 S Memorial Dr
Bixby, OK 74008-2030

Phone

(918) 943-3790

NPI assigned

Dec 28, 2020

Last updated

Dec 28, 2020By the provider in NPPES

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

Enrolled in OK

Opted out of Medicare

Yes, effective Oct 1, 2026 through Oct 1, 2028

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• 918 Family Wellness PLLC

  • Primary Care Clinic/Center
  • Owasso, OK
  • NPI 1073202792
  Medicare reassignment NPD
• Prophylaxis Healthcare LLC

  dba Axis HealthCare

  • Multi-Specialty Clinic/Center
  • Bixby, OK
  • NPI 1538453923

  Family Medicine

  Medicare reassignment NPD
• Prophylaxis Healthcare LLC

  dba Axis Behavioral Health

  • Community/Behavioral Health Agency
  • Bixby, OK
  • NPI 1285438317
  NPD
• Jane Phillips Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Bartlesville, OK
  • NPI 1215914254
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jane Phillips Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Bartlesville, OK
  • NPI 1215914254
  Care Compare affiliation
• Jane Phillips Memorial Medical Center, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Bartlesville, OK
  • NPI 1427428986
  Care Compare affiliation

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1609463587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 334",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740080334",
            "telephone_number": "918-943-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 S MEMORIAL DR",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740082030",
            "telephone_number": "918-943-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADDRICK",
        "first_name": "JULIE",
        "middle_name": "VANG",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "R0118511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Brannon
• Dameko Brewer
• Brian S. Hicks D.C. Inc PC (Bixby Chiropractic Clinic)
• Bright Future Primary Care of Bixby
• Jacqueline Elane Briscoe, RRT
• Brookshire Grocery Company (Reasor's Pharmacy #22)
• Michael T Brummert, PHARMD
• Brush Dentistry LLC (Innovations Dentistry)
• Amber Dawn Burdette
• Stephanie Diane Burleson, D.O.

• Family Medicine Physician in Bixby, OK
• Providers in Bixby, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• 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.

Verify at the official NPI Registry.