Amelia Lillian Broadnax

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

4101 University Ave
San Diego, CA 92105-1418

Phone

(858) 609-9073

NPI assigned

Sep 1, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• GLM House Inc

  • Lodging Provider
  • San Diego, CA
  • NPI 1104628221
  NPD Authorized official

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741996800000",
    "number": "1851672075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1933",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919461933",
            "telephone_number": "858-609-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051418",
            "telephone_number": "858-609-9073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2619 Nida Pl",
            "address_purpose": "LOCATION",
            "city": "Lemon Grove",
            "state": "CA",
            "postal_code": "919452947",
            "country_code": "US",
            "telephone_number": "858-609-9073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROADNAX",
        "first_name": "AMELIA",
        "middle_name": "LILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Edward Brizendine, PH.D
• Brandon Brizuela
• Iris Brizuela
• Ronalyn Rene Brizzie, MA
• Debra Broadbooks, PH.D.
• Linea Broadus, OTR/L
• Charles Broadwater, RN
• Todd G. Broberg, MD
• Tyler David Brobst, MD
• Luke Alan Brochu, IDC

• Case Manager/Care Coordinator in San Diego, CA
• Providers in San Diego, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2025; 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.