Delta Asthma & Allergy

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

12482 Issued in MS

Legal business name

DELTA ASTHMA & ALLERGY

Practice address

2335 Highway 1 S
Greenville, MS 38701-8337

Phone

(662) 378-2762

Fax

(662) 378-9573

NPI assigned

May 30, 2007

Last updated

Jul 1, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charlene B Broome, MDNPI 1720007040

Title

Owner

Phone

(662) 378-2762

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charlene Bell Broome, M.D.

  • Allergy & Immunology Physician
  • Hattiesburg, MS
  • NPI 1720007040
  NPD (past) Authorized official

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1841491404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 HIGHWAY 1 S",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387018337",
            "telephone_number": "662-378-2762",
            "fax_number": "662-378-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 HIGHWAY 1 S",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387018337",
            "telephone_number": "662-378-2762",
            "fax_number": "662-378-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA ASTHMA & ALLERGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "BROOME",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-378-2762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MS",
            "license": "12482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "587763099",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015689",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MS",
            "identifier": "587763099B",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maranda Davis, L.P.C.
• Malcolm Dean
• Veronica Winters Deering
• Kristin Delahoussaye, FNP-BC
• Delta Area Hospice Care Limited
• Delta Chiropractic, Inc.
• Delta Community Mental Health
• Delta Community Mental Health Services
• Delta Community Mental Health Services
• Delta Critical Care & Lung Consultants P.C.

• Allergy & Immunology Physician in Greenville, MS
• Providers in Greenville, MS by specialty
• Allergy & Immunology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.