Individual provider Active NPI

Linda Marie Broch, RN

  • Registered Nurse
  • Saint Louis, MO
National Provider Identifier
1679725931
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2005008820 Issued in MO
Practice address
228 Kingston Dr
Apartment C
Saint Louis, MO 63125-2939
Phone
(314) 845-7950
NPI assigned
Oct 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2005008820 MO Primary

Addresses

Primary practice location

228 Kingston Dr
Apartment C
Saint Louis, MO 63125-2939

Mailing address

228 Kingston Dr
Apartment C
Saint Louis, MO 63125-2939
Phone (314) 845-7950

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2005008820MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1679725931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 KINGSTON DR",
            "address_2": "APARTMENT C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631252939",
            "telephone_number": "314-845-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 KINGSTON DR",
            "address_2": "APARTMENT C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631252939",
            "telephone_number": "314-845-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCH",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2005008820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.