Trent Michael Broadus, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95006008 Issued in CA

Practice address

1695 N Sunrise Way
Palm Springs, CA 92262-3701

Phone

(760) 323-2118

Fax

(760) 416-1651

NPI assigned

Sep 21, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbroadus212855@direct.ochin.org

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.

• Dap Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Palm Springs, CA
  • NPI 1306464326
  Medicare reassignment
• Dap Health Inc

  • Infectious Disease Physician
  • Palm Springs, CA
  • NPI 1568439081
  NPD
• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1780967364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 NORTH SUNRISE WAY",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922623701",
            "telephone_number": "760-323-2118",
            "fax_number": "760-416-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 N SUNRISE WAY",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922623701",
            "telephone_number": "760-323-2118",
            "fax_number": "760-416-1651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 N McMullen Booth Rd",
            "address_2": "Suite D1",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337592130",
            "country_code": "US",
            "telephone_number": "727-669-3800",
            "fax_number": "727-669-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROADUS",
        "first_name": "TRENT",
        "middle_name": "MICHAEL",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9353539",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "570228",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95006008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA NP LICENSE",
            "identifier": "95006008",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLA MEDICAL LICENSE",
            "identifier": "ARNP9353539",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dustin T Briggs, MD
• Monica Urias Brighindi
• Brighton Cardiology PC
• James Stephen Brinkman
• Corazon Cabcad Brittain, FNP-C
• Bridgett Ann Brock
• Scott David Brook, M.D.
• Linda L Brooks
• Robin Bernal Brooks, M.S.W.
• Stanton Layne Brosamle, MS MFT

• Nurse Practitioner in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.