Individual provider Active NPI

Denise Mishelle Broersma, D.C.

  • Chiropractor
  • Tucson, AZ
National Provider Identifier
1760668263
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5972 Issued in AZ
Practice address
5230 E 8TH St
Tucson, AZ 85711-3105
Phone
(520) 327-3099
NPI assigned
Jan 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5972 AZ Primary

Addresses

Primary practice location

5230 E 8TH St
Tucson, AZ 85711-3105

Mailing address

5230 E 8TH St
Tucson, AZ 85711-3105
Phone (520) 327-3099

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5972AZMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1760668263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 E 8TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113105",
            "telephone_number": "520-327-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 E 8TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113105",
            "telephone_number": "520-327-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROERSMA",
        "first_name": "DENISE",
        "middle_name": "MISHELLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.