Carol Broom

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

737648 Issued in TX

Practice address

992 E US Highway 80
Forney, TX 75126-8709

Phone

(972) 552-2920

NPI assigned

Mar 3, 2014

Sex

Female

Sole proprietor

No

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

Enrolled in TX

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

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.

• Shibli Family Medicine and Obesity Clinic PLLC

  • Family Medicine Physician
  • Mesquite, TX
  • NPI 1093478489
  Medicare reassignment NPD

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1841615796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 DOWELL RD",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327172",
            "telephone_number": "972-948-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 E US HIGHWAY 80",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751268709",
            "telephone_number": "972-552-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOM",
        "first_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "737648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathon Scott Brierley, MSAT, LAT, ATC
• Bright Beginnings Speech Therapy LLC
• Brightling Home Care LLC
• Brooks Jenkins, LLC
• Brookshire Grocery Company
• Brown Angel'S Residential LLC
• Brittany Rene Brown Vrabel, DPT
• Senray Sachae Brown-Shelling, NA
• Colby D Brown
• Jazmine Shanae Brown

• Family Nurse Practitioner in Forney, TX
• Providers in Forney, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.