Active NPI
Mary Dawson Broga, MD
- Specialist
- Richmond, VA
National Provider Identifier
1669426300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0101102526
- Practice address
- 5801 Bremo Rd
Richmond, VA 23226-1907 - Phone
- (804) 281-8222
- Fax
- (804) 281-8007
- NPI assigned
- May 19, 2006
- Last updated
- Sep 11, 2025
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 0101102526 | VA | Primary |
| Pediatrics Physician | 208000000X | NC |
Addresses
Primary practice location
5801 Bremo Rd
Richmond, VA 23226-1907
Mailing address
4209 W Franklin St
Richmond, VA 23221-1109
Phone (804) 545-0502
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 |
|---|---|---|---|
| 200500372 | NC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ri, LP | Past | Accepting new patients |
Interoperability endpoints
- marybroga@rpapa.allscriptsdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1669426300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4209 W FRANKLIN ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232211109",
"telephone_number": "804-545-0502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5801 BREMO RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232261907",
"telephone_number": "804-281-8222",
"fax_number": "804-281-8007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROGA",
"first_name": "MARY",
"middle_name": "DAWSON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "VA",
"license": "0101102526",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.