Individual provider Active NPI

Kimberly Broadway, MSN, APN-C

  • Family Nurse Practitioner
  • Moorestown, NJ
National Provider Identifier
1669880225
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00497600 Issued in NJ
Practice address
401 Young Ave Ste 180 Front
Moorestown, NJ 08057-3139
Phone
(856) 291-8600
Fax
(856) 291-8610
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00497600 NJ Primary

Addresses

Primary practice location

401 Young Ave Ste 180 Front
Moorestown, NJ 08057-3139

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other practice location 1

128 Route 70 Ste 1
Medford, NJ 08055-2371
Phone (609) 367-0900

Other practice location 2

315 Route 70 E
Cherry Hill, NJ 08034-2408
Phone (856) 375-6240

Other practice location 3

602 W Cuthbert Blvd Unit 26
Haddon Township, NJ 08108-3642
Phone (856) 946-5180

Other practice location 4

158 Route 73 Ste B
Voorhees, NJ 08043-9539
Phone (856) 247-7230

Other practice location 5

239 Hurffville Crosskeys Rd Ste 160
Sewell, NJ 08080-4005
Phone (856) 341-8200

Other practice location 6

141 Bridgeton Pike Unit B
Mullica Hill, NJ 08062-2615
Phone (856) 746-0206

Other practice location 7

555 High St Ste 16A
Mount Holly, NJ 08060-1084
Phone (609) 444-5610

Other identifiers 1

IdentifierTypeStateIssuer
0434191MedicaidNJ

Electronic endpoints 7

TypeEndpointUseAffiliation
Direct Messaging Address kbroadway100713@directvirtua.org
Direct Messaging Address kbroadway100713@directvirtua.org
Direct Messaging Address kbroadway100713@directvirtua.org
Direct Messaging Address kbroadway100713@directvirtua.org
Direct Messaging Address kbroadway100713@directvirtua.org
Direct Messaging Address kbroadway100713@directvirtua.org
Direct Messaging Address kbroadway100713@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140918001352 NJ Practitioner - Nurse Practitioner 7012136393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

239 Hurffville Crosskeys Rd
Suite 160
Sewell, NJ 08080-4005
Phone (856) 341-8200

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
26NJ00497600NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 12, 2019 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 12, 2019 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

315 Route 70 E
Cherry Hill, NJ 08034
Phone (856) 375-6240

602 W Cuthbert Blvd
Unit 26
Haddon Township, NJ 08108
Phone (856) 946-5180

303 Lippincott Dr
Marlton, NJ 08053

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

128 Route 70
Ste 1
Medford, NJ 08055
Phone (609) 367-0900

401 Young Ave
Ste 180
Moorestown, NJ 08057
Phone (856) 291-8600

555 High St
Ste 16A
Mount Holly, NJ 08060
Phone (609) 444-5610

141 Bridgeton Pike
Unit B
Mullica Hill, NJ 08062
Phone (856) 746-0206

239 Hurffville Crosskeys Rd
Ste 160
Sewell, NJ 08080
Phone (856) 341-8200

158 Route 73
#B
Voorhees, NJ 08043
Phone (856) 247-7230

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1669880225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 YOUNG AVE STE 180 FRONT",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573139",
            "telephone_number": "856-291-8600",
            "fax_number": "856-291-8610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 Route 70 Ste 1",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NJ",
            "postal_code": "080552371",
            "country_code": "US",
            "telephone_number": "609-367-0900",
            "fax_number": "609-367-0901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 Route 70 E",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080342408",
            "country_code": "US",
            "telephone_number": "856-375-6240",
            "fax_number": "856-375-6241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "602 W Cuthbert Blvd Unit 26",
            "address_purpose": "LOCATION",
            "city": "Haddon Township",
            "state": "NJ",
            "postal_code": "081083642",
            "country_code": "US",
            "telephone_number": "856-946-5180",
            "fax_number": "856-946-5181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "158 Route 73 Ste B",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439539",
            "country_code": "US",
            "telephone_number": "856-247-7230",
            "fax_number": "856-247-7231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "239 Hurffville Crosskeys Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080804005",
            "country_code": "US",
            "telephone_number": "856-341-8200",
            "fax_number": "856-341-8215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "141 Bridgeton Pike Unit B",
            "address_purpose": "LOCATION",
            "city": "Mullica Hill",
            "state": "NJ",
            "postal_code": "080622615",
            "country_code": "US",
            "telephone_number": "856-746-0206",
            "fax_number": "856-746-0207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 High St Ste 16A",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NJ",
            "postal_code": "080601084",
            "country_code": "US",
            "telephone_number": "609-444-5610",
            "fax_number": "609-444-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROADWAY",
        "first_name": "KIMBERLY",
        "credential": "MSN, APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00497600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0434191",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbroadway100713@directvirtua.org",
            "affiliation": "N",
            "address_1": "239 Hurffville Crosskeys Rd Ste 160",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbroadway100713@directvirtua.org",
            "affiliation": "N",
            "address_1": "141 Bridgeton Pike Unit B",
            "city": "Mullica Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080622615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbroadway100713@directvirtua.org",
            "affiliation": "N",
            "address_1": "555 High St Ste 16A",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080601084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbroadway100713@directvirtua.org",
            "affiliation": "N",
            "address_1": "158 Route 73 Ste B",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbroadway100713@directvirtua.org",
            "affiliation": "N",
            "address_1": "315 Route 70 E",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080342408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbroadway100713@directvirtua.org",
            "affiliation": "N",
            "address_1": "128 Route 70 Ste 1",
            "city": "Medford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080552371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbroadway100713@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 180 Front",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.