Active NPI
Terencia Broaden
- Certified Registered Nurse Anesthetist
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1176796
- Practice address
- 12222 Merit Dr Ste 600
Dallas, TX 75251-3294 - Phone
- (972) 715-5000
- Fax
- (972) 715-9976
- NPI assigned
- Jul 10, 2024
- Last updated
- Dec 31, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1-157348 | AL | |
| Certified Registered Nurse Anesthetist | 367500000X | 1176796 | TX | Primary |
| Registered Nurse | 163W00000X | 1-157348 | AL |
Addresses
Primary practice location
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Mailing address
152 Moore Dr
Cecil, AL 36013-3003
Phone (334) 328-2330
Other practice location 1
152 Moore Dr
Cecil, AL 36013-3003
Phone (334) 328-2330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, AL, TN
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451
1900 Pine St
Abilene, TX 79601-2432
Phone (325) 670-2000
2105 E S Blvd
Montgomery, AL 36116-2409
Phone (334) 286-3579
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 390-0451
5000 Medical W Way
Bessemer, AL 35022-7082
Phone (205) 481-7000
619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-157348 | AL | MD | Certified Registered Nurse Anesthetist |
| 1176796 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| U S Anesthesia Partners of Texas, PA | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Paragon Anesthesia PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| U. S. Anesthesia Partners of Texas, P.a., | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| East Tennessee Ambulatory Surgery Center LLC | Current | Accepting new patients | |
| Premier Anesthesia of Montgomery PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Hendrick Anesthesia Network | Current | Accepting new patients | |
| Singing River Health System | Past | Accepting new patients |
Locations
2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451
1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220
751 N 18th St
Abilene, TX 79601
Phone (915) 676-0557
1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000
12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 776-3185
100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555
9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300
Organizations & group practices 9
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Abilene, TX
- NPI 1851394993
-
- Anesthesiology Physician
- Kingsport, TN
- NPI 1538174974
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Montgomery, AL
- NPI 1780636233
Nurse Anesthetist, Certified Registered
-
dba UAB Medical West
- Multi-Specialty Clinic/Center
- Bessemer, AL
- NPI 1952483729
-
- Multi-Specialty Clinic/Center
- Birmingham, AL
- NPI 1093768723
-
dba Greater Houston Anesthesiology, P.A.
- Anesthesiology Physician
- Houston, TX
- NPI 1548208564
Nurse Anesthetist, Certified Registered
-
- Interventional Pain Medicine Physician
- Addison, TX
- NPI 1053800391
Nurse Anesthetist, Certified Registered
-
- Ambulatory Surgical Clinic/Center
- Johnson City, TN
- NPI 1659360071
-
dba Inpatient Physician Services
- Internal Medicine Physician
- Pascagoula, MS
- NPI 1134283419
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Abilene, TX
- NPI 1528064649
-
dba Baptist Medical Center South
- General Acute Care Hospital
- Montgomery, AL
- NPI 1700977105
-
dba Woodridge Hospital
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1023434339
-
dba Johnson City Medical Center
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1962915652
-
dba Johnson City Medical Center
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
-
- General Acute Care Hospital
- Birmingham, AL
- NPI 1154435824
-
- General Acute Care Hospital
- Birmingham, AL
- NPI 1447145818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735603200000",
"number": "1932946548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 MOORE DR",
"city": "CECIL",
"state": "AL",
"postal_code": "360133003",
"telephone_number": "334-328-2330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12222 MERIT DR STE 600",
"city": "DALLAS",
"state": "TX",
"postal_code": "752513294",
"telephone_number": "972-715-5000",
"fax_number": "972-715-9976"
}
],
"practiceLocations": [
{
"address_1": "152 Moore Dr",
"address_purpose": "LOCATION",
"city": "Cecil",
"state": "AL",
"postal_code": "360133003",
"country_code": "US",
"telephone_number": "334-328-2330",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROADEN",
"first_name": "TERENCIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-10",
"last_updated": "2024-12-31",
"certification_date": "2024-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AL",
"license": "1-157348",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "1176796",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AL",
"license": "1-157348",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.