Havilah Noel Brodhead, R.N., MSN, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

201407546NP-PP Issued in OR

Practice address

339 SW Century Dr Ste 201
Bend, OR 97702-1338

Phone

(541) 316-5693

Fax

(541) 255-0947

NPI assigned

Jun 7, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Havilah Liederbach Former name

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healing Roots Medicine LLCGroup PAC ID 5597095620, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: havilah.brodhead.1@27559.direct.athenahealth.com

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.

• Healing Roots Medicine LLC

  • Primary Care Clinic/Center
  • Bend, OR
  • NPI 1477051795
  Medicare reassignment Care Compare group Authorized official
• Paulina Peak Family Healthcare Inc

  • Family Nurse Practitioner
  • La Pine, OR
  • NPI 1184784332
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cascade Healthcare Community Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1841584844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 SW CENTURY DR STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021338",
            "telephone_number": "541-315-5693",
            "fax_number": "541-255-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 SW CENTURY DR STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021338",
            "telephone_number": "541-316-5693",
            "fax_number": "541-255-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODHEAD",
        "first_name": "HAVILAH",
        "middle_name": "NOEL",
        "name_prefix": "Mrs.",
        "credential": "R.N., MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OR",
            "license": "201407546NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500678393",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAVILAH",
            "last_name": "LIEDERBACH",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Kathryn Brock
• Suzanne Lynn Brock
• Antoinette Brockman, O.T.
• Charles Edman Brockman, PT
• Valerie Brodbeck, QMHP
• Jeremy Brodhead, N.P.
• Deanna Troi Brodsky, LMT
• Broken Top Counseling, LLC
• Brookdale Senior Living Communities, Inc.
• Eva Averie Brookie, LMHC, LPC, CRC

• Primary Care Nurse Practitioner in Bend, OR
• Providers in Bend, OR by specialty
• Primary Care Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.