Individual provider Active NPI

Aaron Wilton Broadwell, MD

  • Rheumatology Physician
  • Shreveport, LA
National Provider Identifier
1851554786
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD.205607 Issued in LA
Practice address
820 Jordan St
Suite 201
Shreveport, LA 71101-4518
Phone
(318) 221-0399
Fax
(318) 221-1940
NPI assigned
Jul 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD.205607 LA Primary

Addresses

Primary practice location

820 Jordan St
Suite 201
Shreveport, LA 71101-4518

Mailing address

820 Jordan St
Suite 201
Shreveport, LA 71101-4518
Phone (318) 221-0399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120919000530 LA Practitioner - Rheumatology 4688822414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Texas Medical Branch at Galveston, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Larry K. Broadwell, M.D., a Medical CorporationGroup PAC ID 7113984402, 10 clinicians

Practice addresses (Care Compare)

820 Jordan St
Suite 201
Shreveport, LA 71101-4519
Phone (318) 221-0399

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
  • Springhill Medical Center Hospital, Springhill, LA, CCN 190088
  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041

Merit-based Incentive Payment System (MIPS)

Final score
79.48 of 100Reported as individual
Quality
83.78
Improvement activities
40
Cost
53.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.205607LAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatology and Osteoporosis Specialists, AMC Rheumatology CurrentSince Sep 1, 2012 Accepting new patients
Rheumatology and Osteoporosis Specialists, AMC CurrentSince May 11, 2025 Accepting new patients

Locations

820 Jordan St
Ste 201
Shreveport, LA 71101
Phone (318) 221-0399

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAJHBA

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1851554786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 JORDAN ST",
            "address_2": "SUITE 201",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014518",
            "telephone_number": "318-221-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 JORDAN ST",
            "address_2": "SUITE 201",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014518",
            "telephone_number": "318-221-0399",
            "fax_number": "318-221-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWELL",
        "first_name": "AARON",
        "middle_name": "WILTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "LA",
            "license": "MD.205607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.