Individual provider Active NPI

Christopher Michael Broadway, M.D.

  • Family Medicine Physician
  • Waxahachie, TX
National Provider Identifier
1639308836
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P8016 Issued in TX
Practice address
1700 N Highway 77 Ste 210
Waxahachie, TX 75165-7832
Phone
(972) 937-1210
Fax
(972) 937-0243
NPI assigned
Jul 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P8016 TX Primary

Addresses

Primary practice location

1700 N Highway 77 Ste 210
Waxahachie, TX 75165-7832

Mailing address

1700 N Highway 77 Ste 210
Waxahachie, TX 75165-7832
Phone (972) 937-1210

Other identifiers 1

IdentifierTypeStateIssuer
8DZ581OtherTXBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131230000517 TX Practitioner - Family Practice 9739335787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians
Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians

Practice addresses (Care Compare)

1700 N Hwy 77
Suite 210
Waxahachie, TX 75165-7832
Phone (972) 937-1210

6116 Lake Worth Blvd
Lake Worth, TX 76135-3703
Phone (817) 984-3260

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth Family Medicine CurrentSince Nov 11, 2013 Accepting new patients
Medhealth CurrentSince Nov 11, 2013 Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients
Creighton University Family Medicine Past Accepting new patients
Creighton University Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

3400 W Wheatland Rd
Ste 360
Dallas, TX 75237

3400 W Wheatland Rd
Dallas, TX 75237

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

1700 N Highway 77
Ste 210
Waxahachie, TX 75165
Phone (817) 453-3500

1410 W Jefferson St
Waxahachie, TX 75165
Phone (972) 937-1210

613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700

Interoperability endpoints

  • Direct secure messaging: cbroadway14305@dm.mhd.com

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1639308836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N HIGHWAY 77 STE 210",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751657832",
            "telephone_number": "972-937-1210",
            "fax_number": "972-937-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N HIGHWAY 77 STE 210",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751657832",
            "telephone_number": "972-937-1210",
            "fax_number": "972-937-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWAY",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-08",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P8016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8DZ581",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

Verify at the official NPI Registry.