Paul W Broadbent, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

3130701205 Issued in UT

Practice address

1034 North 500 West
Provo, UT 84604

Phone

(801) 373-7850

NPI assigned

Jun 7, 2006

Last updated

Oct 15, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381795200000",
    "number": "1871533836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846600010",
            "telephone_number": "866-898-7136",
            "fax_number": "616-975-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 NORTH 500 WEST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-373-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADBENT",
        "first_name": "PAUL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "3130701205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930046707",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D1365",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Garret Bringhurst, OD
• Kyle Don Bringhurst, MSWI
• Lacey Bringhurst, PHARMD
• Sachiko Briscoe, CMHC
• David Harrison Broadbent, MD
• Cassie K Broadhead, PA-C
• Jeffrey Charles Broberg, M.D.
• Kathryn Larue Broberg
• David Wesley Brock, PA-C
• Disa T. Brock

• Emergency Medical Services (Emergency Medicine) Physician in Provo, UT
• Providers in Provo, UT by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; 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.