Individual provider Active NPI

Faidah O Badru, MD

  • Pediatric Surgery Physician
  • Lubbock, TX
National Provider Identifier
1740613629
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
W0362 Issued in TX
Practice address
4102 22ND PL
Lubbock, TX 79410-1122
Phone
(806) 725-0237
Fax
(806) 725-1030
NPI assigned
Aug 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 1828418 MO
Pediatric Surgery Physician 2086S0120X 94191 SC
Surgery Physician 208600000X 0101277902 VA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Surgery Physician 2086S0120X W0362 TX Primary

Addresses

Primary practice location

4102 22ND PL
Lubbock, TX 79410-1122

Mailing address

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5228

Other practice location 1

9 Richland Medical Park Dr Ste 500
Columbia, SC 29203-6870
Phone (803) 434-4555

Other practice location 2

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-1000

Other practice location 3

4348 Electric Rd
Roanoke, VA 24018-0720
Phone (540) 769-0976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, DE, VA, SC, TX5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20221205003129 WV Practitioner - General Surgery 5496057879 Reassigns benefits to 1 organization
I20230418001950 DE Practitioner - General Surgery 5496057879 Reassigns benefits to 1 organization
I20230508000443 VA Practitioner - General Surgery 5496057879 Reassigns benefits to 1 organization
I20250515001704 SC Practitioner - General Surgery 5496057879 Reassigns benefits to 1 organization
I20250930000169 TX Practitioner - General SurgeryPractitioner - Pediatric Medicine 5496057879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Pediatric Medicine
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2215 Nashville Ave
Lubbock, TX 79410-1105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1828418MOMDSurgery Physician
0101277902VAMDSurgery Physician
94191SCMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince May 9, 2025 Accepting new patients
Carilion Medical Center CurrentSince Jun 29, 2023 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Oct 4, 2022 Accepting new patients
Prisma Health Medical Group-Midlands Surgery CurrentSince May 9, 2025 Accepting new patients
The Nemours Foundation CurrentSince Apr 1, 2023 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Oct 4, 2022 Accepting new patients
The Nemours Foundation CurrentSince Apr 1, 2023 Accepting new patients
Covenant Medical Group Surgery CurrentSince Oct 1, 2025 Accepting new patients
Covenant Medical Group CurrentSince Oct 1, 2025 Accepting new patients
Carilion Medical Center CurrentSince Jun 29, 2023 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Methodist Children'S Hospital Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

9 Richland Medical Park Dr
Ste 500
Columbia, SC 29203
Phone (803) 344-4555

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

4102 22nd Pl
Lubbock, TX 79410
Phone (806) 725-0237

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

830 Pennsylvania Ave
Ste 202
Charleston, WV 25302
Phone (304) 388-1770

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

Interoperability endpoints

  • Direct secure messaging: fbadru843762@direct.ghs.myhfn.org

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1740613629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5228",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101122",
            "telephone_number": "806-725-0237",
            "fax_number": "806-725-1030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Richland Medical Park Dr Ste 500",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036870",
            "country_code": "US",
            "telephone_number": "803-434-4555",
            "fax_number": "803-434-4599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "506 Lenox Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100371802",
            "country_code": "US",
            "telephone_number": "212-939-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4348 Electric Rd",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240180720",
            "country_code": "US",
            "telephone_number": "540-769-0976",
            "fax_number": "540-857-5383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BADRU",
        "first_name": "FAIDAH",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "1828418",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "SC",
            "license": "94191",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101277902",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "W0362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.