NPIMap

Individual provider Active NPI

Denise Ann Broderick, M.D.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1942250980
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
18473 Issued in SC
Practice address
330C Pelham Rd
Suite 101C
Greenville, SC 29615
Phone
(864) 720-1299
Fax
(864) 720-1300
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 18473 SC Primary

Addresses

Primary practice location

330C Pelham Rd
Suite 101C
Greenville, SC 29615

Mailing address

330 C Pelham Road
Suite a
Greenville, SC 29615
Phone (864) 720-1299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050106000371 SC Practitioner - Obstetrics/Gynecology 9032167028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical University of South Carolina College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ps121 Management PAGroup PAC ID 2264786706, 5 clinicians

Practice addresses (Care Compare)

330 C Pelham Rd
Suite a
Greenville, SC 29615-3111
Phone (864) 720-1299

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ps121 Management PA Obstetrics & Gynecology CurrentSince Jun 29, 2018 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 7, 2014 Accepting new patients
Prisma Health University Medical Group Obstetrics & Gynecology CurrentSince Jan 7, 2014 Accepting new patients
Greenville Health System Past Accepting new patients
Apex Allergy & Immunology, P.C. PastSince Jan 1, 2018 Accepting new patients
Coastal Anesthesia Medical Group, LLC Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

48 Cross Park Ct
Greenville, SC 29605
Phone (864) 235-1122

330C Pelham Rd
#A
Greenville, SC 29615
Phone (864) 720-1299

274 Commonwealth Dr
Ste A
Greenville, SC 29615
Phone (864) 686-5511

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

Interoperability endpoints

  • Direct secure messaging: dbroderick5635@direct.ghs.myhfn.org

Organizations & group practices 6

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.

Hospital & facility affiliations 54

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1942250980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 C PELHAM ROAD",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29615",
            "telephone_number": "864-720-1299",
            "fax_number": "864-720-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330C PELHAM RD",
            "address_2": "SUITE 101C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29615",
            "telephone_number": "864-720-1299",
            "fax_number": "864-720-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "DENISE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "18473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.