Scarlette Renee Broadway, FNP
Individual provider Active NPI Family Nurse Practitioner · Washington, NC
NPI 1679455778 · NPPES record last updated Jul 29, 2025
Key facts
- NPI
- 1679455778
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5022658 (NC)
- Practice address
- 623 W 15TH St
Washington, NC 27889-3526 - Phone
- (252) 644-6450
- Fax
- (252) 644-6451
- NPI assigned
- Jul 22, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Kentucky, PLLC
Practice addresses (Care Compare)
623 W 15TH St
Washington, NC 27889-3526
Phone (252) 644-6450
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250815001182 | NC | Practitioner - Nurse Practitioner | 8527567734 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5022658 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Fast Pace Kentucky PLLC | Current |
Accepting new patients | |
| Fast Pace Kentucky, PLLC | Current |
Accepting new patients |
Locations
212 S Tryon St
Ste 100
Charlotte, NC 28281
1515 Mockingbird Ln
Ste 420
Charlotte, NC 28209
Phone (310) 230-5984
623 W 15th St
Washington, NC 27889
Phone (252) 644-6450
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5022658 | NC | Yes |
Addresses
Primary practice location
623 W 15TH St
Washington, NC 27889-3526
Mailing address
PO Box 306599
Nashville, TN 37230-6599
Phone (252) 644-6450
Other providers in Washington, NC
- Pamela Lynn Brinn
- Britt'S Elite Transport LLC
- Britthaven, Inc.
- Eileen Britton
- Codie Brixey
- Nancy Brous-Distefano
- Brown Chiropractic Group PC
- Jewel Brown-Thomas
- Chelsie K Brown
- Elizabeth Anne Brown
All providers in Washington, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.