Elizabeth M Broughal

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306605921 Issued in VA

Practice address

2978 Centreville Rd # B20171
Herndon, VA 20171-6253

Phone

(703) 934-5000

NPI assigned

Dec 5, 2021

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

Other names 1

• Elizabeth M Range Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1638662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1891453023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14830 EDMAN CIR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201214497",
            "telephone_number": "845-479-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2978 CENTREVILLE RD # B20171",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201716253",
            "telephone_number": "703-934-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHAL",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-05",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306605921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "RANGE",
            "middle_name": "M",
            "credential": "BS PTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alnora L Brassell, NURSE PRACTITIONER
• Rachel Danielle Brennan, DPT
• Brightview Residential Care
• Marin H Bronaugh, DPT, PT
• Lindsey Brooks
• Abdullah Brown, MD
• Elizabeth Marie Brown, RD
• Micah Brown
• Riley Brunelle
• Adam Brunkhorst

• All providers in Herndon, VA
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2021; 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.