NPIMap

Organization Active NPI

Nephrology Consultants LLC

  • Nephrology Physician
  • Huntsville, AL
National Provider Identifier
1699874222
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY CONSULTANTS LLC
Practice address
2780 Bob Wallace Ave SW
Suite E
Huntsville, AL 35805-4104
Phone
(256) 533-4626
Fax
(256) 533-4710
NPI assigned
Sep 21, 2006
Last updated
Jul 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Authorized official

Name
Dr. Todd A Broome, MDNPI 1588636757
Title
Administrative Physician Partner
Phone
(256) 533-4626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

2780 Bob Wallace Ave SW
Suite E
Huntsville, AL 35805-4104

Mailing address

2780 Bob Wallace Ave SW
Suite E
Huntsville, AL 35805-4104
Phone (256) 533-4626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040308000709 AL Part B Supplier - Clinic/Group Practice 5092603472 Receives reassigned benefits from 19 practitioners
Practice locations: Huntsville, AL
O20040914001415 TN Part B Supplier - Clinic/Group Practice 5092603472 Receives reassigned benefits from 7 practitioners
Practice locations: Fayetteville, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0886232Nephrology Consultants LLC2780 Bob Wallace Avenue, Huntsville, AL 35805Certificate of waiverMay 13, 2028

National Provider Directory

National Provider Directory

Locations

1311 Memorial Pkwy NW
Huntsville, AL 35801
Phone (256) 535-5008

1675 Sparkman Dr NW
Huntsville, AL 35816
Phone (256) 722-0013

2780 Bob Wallace Ave SW
Ste E
Huntsville, AL 35805
Phone (256) 533-4626

106 Medical Center Blvd
Ste 106
Fayetteville, TN 37334

106 Medical Center Blvd
Ste 125
Fayetteville, TN 37334

2218 Thornton Taylor Pkwy
Fayetteville, TN 37334
Phone (931) 438-2399

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342396800000",
    "number": "1699874222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 BOB WALLACE AVE SW",
            "address_2": "SUITE E",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054104",
            "telephone_number": "256-533-4626",
            "fax_number": "256-533-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 BOB WALLACE AVE SW",
            "address_2": "SUITE E",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054104",
            "telephone_number": "256-533-4626",
            "fax_number": "256-533-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-07-16",
        "status": "A",
        "authorized_official_last_name": "BROOME",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATIVE PHYSICIAN PARTNER",
        "authorized_official_telephone_number": "256-533-4626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.