Active NPI
Dora Miroslava Brodie, M.D.
- Gastroenterology Physician
- Greensboro, NC
National Provider Identifier
1609838341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 20161
- Practice address
- 520 N Elam Ave
Greensboro, NC 27403-1127 - Phone
- (336) 547-1700
- Fax
- (336) 547-1828
- NPI assigned
- Apr 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 20161 | NC | |
| Gastroenterology Physician | 207RG0100X | 20161 | NC | Primary |
Addresses
Primary practice location
520 N Elam Ave
Greensboro, NC 27403-1127
Mailing address
1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4098074 | Other | NC | AETNA PROVIDER NUMBER |
| 27058 | Other | NC | MEDCOST PROVIDER NUMBER |
| 616 | Other | NC | PARTNERS MEDICARE PROV # |
| 8951893 | Medicaid | NC | |
| 51893 | Other | NC | BCBS NC PROVIDER NUMBER |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20161 | NC | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386547200000",
"number": "1609838341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N ELM ST",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274011004",
"telephone_number": "336-832-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 N ELAM AVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274031127",
"telephone_number": "336-547-1700",
"fax_number": "336-547-1828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODIE",
"first_name": "DORA",
"middle_name": "MIROSLAVA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-06",
"last_updated": "2013-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "20161",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NC",
"license": "20161",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "4098074",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST PROVIDER NUMBER",
"identifier": "27058",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS MEDICARE PROV #",
"identifier": "616",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8951893",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC PROVIDER NUMBER",
"identifier": "51893",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.