Emma Penelope Broderick

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1791 Issued in MN

Practice address

1211 James Ave
Saint Paul, MN 55105-2920

Phone

(651) 295-8536

NPI assigned

Nov 29, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1922512805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 JAMES AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052920",
            "telephone_number": "651-295-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 JAMES AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052920",
            "telephone_number": "651-295-8536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 W 40th St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554091406",
            "country_code": "US",
            "telephone_number": "612-823-0012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "EMMA",
        "middle_name": "PENELOPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emma@emmapenelope.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1211 James Ave",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551052920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Britton Center, P.a.
• Alain F Broccard, MD
• Megan Brock, PA-C
• James Arthur Brockberg, MD
• Debra Jean Broderick, PYS.D.
• Tara Vonne Brodersen, DDS
• Jane S Brodie, PHD
• Peter Samuel Brodrick, MD
• Andrea Brody, PA-C
• Richard Jay Brody, M.D.

• Acupuncturist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Acupuncturist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.