Active NPI
Robert Julian Broome III, RN
- Registered Nurse
- Charlotte, NC
National Provider Identifier
1770915845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 222159
- Practice address
- 8601 University East Dr
Charlotte, NC 28213-4353 - Phone
- (704) 597-3500
- NPI assigned
- Jul 31, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 222159 | NC | Primary |
Addresses
Primary practice location
8601 University East Dr
Charlotte, NC 28213-4353
Mailing address
1074 Burning Embers LN
Concord, NC 28025-8811
Phone (704) 597-3500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 222159 | NC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1770915845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1074 BURNING EMBERS LN",
"city": "CONCORD",
"state": "NC",
"postal_code": "280258811",
"telephone_number": "704-597-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8601 UNIVERSITY EAST DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282134353",
"telephone_number": "704-597-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOME",
"first_name": "ROBERT",
"middle_name": "JULIAN",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-31",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "222159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.