Walter Evan Brodis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1880451205 Issued in UT

Practice address

2041 E 6025 S
Ogden, UT 84403-5270

Phone

(801) 479-6574

NPI assigned

Jan 26, 2009

Last updated

Jan 26, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: walter.brodis@617171141001220.direct.elationemr.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.

• Walter E Brodis PLLC

  • Clinic/Center
  • Ogden, UT
  • NPI 1073384814

  Internal Medicine

  NPD Authorized official

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1821236035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 E 6025 S",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844035270",
            "telephone_number": "801-479-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 E 6025 S",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844035270",
            "telephone_number": "801-479-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODIS",
        "first_name": "WALTER",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "1880451205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey P Broadbent, DMD
• Michael William Broadbent, DMD, M.S.
• Melanie Ann Broadhead
• Mark Steven Broccardo, COTA
• Raymond Donald Brock, CPSS
• David E Brodstein, M.D.
• Aaron Matthew Bronson, CRNA
• Alan Wayne Brooks, LMFT
• Chet David Brooks, LMFT
• Paige Brooks, APRN, DNP-PMHNP

• Internal Medicine Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.