Charlene Bell Broome, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

12482 Issued in MS

Practice address

6414 U S Highway 98
Ste 80
Hattiesburg, MS 39402-7815

Phone

(601) 261-1800

Fax

(601) 261-1801

NPI assigned

Jul 18, 2006

Last updated

Aug 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbroome54890@directpatientrecord.com

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.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment NPD
• Delta Asthma & Allergy

  • Allergy & Immunology Physician
  • Greenville, MS
  • NPI 1841491404
  NPD (past) Authorized official
• Hattiesburg Clinic, PA

  dba Flowood Primary Care

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• Mississippi Asthma & Allergy Clinic PA

  • Allergy & Immunology Physician
  • Jackson, MS
  • NPI 1902882251
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1720007040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-1800",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6414 U S HIGHWAY 98",
            "address_2": "STE 80",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394027815",
            "telephone_number": "601-261-1800",
            "fax_number": "601-261-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "CHARLENE",
        "middle_name": "BELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "12482",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MS",
            "license": "12482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbroome54890@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6414 U S Highway 98",
            "address_2": "Ste 80",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394027815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Beyonce Brock
• Marty Jacob Brock, DPT
• Honey Brooks, OTR
• Shalisha Brooks, PCMHT
• Tommy Brooks, HIS
• Stephanie Broome
• Gerald B Broussard Jr., MD
• Heath Jude Broussard II, DO
• Brown Behavioral Health Group
• Janice Brown-Jones

• Allergy & Immunology Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Allergy & Immunology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.