Individual provider Active NPI

Jennifer Anne House-Brodziak, ACUPUNCTURIST

  • Acupuncturist
  • Deerfield Beach, FL
National Provider Identifier
1952422438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AP 1878 Issued in FL
Practice address
3836 W Hillsboro Blvd
Deerfield Beach, FL 33442-9413
Phone
(954) 428-4747
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AP 1878 FL Primary

Addresses

Primary practice location

3836 W Hillsboro Blvd
Deerfield Beach, FL 33442-9413

Mailing address

504 NW 6TH Way
Boynton Beach, FL 33426-2967
Phone (561) 740-7569

Other identifiers 1

IdentifierTypeStateIssuer
C0986OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP 1878FLMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952422438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 NW 6TH WAY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334262967",
            "telephone_number": "561-740-7569",
            "fax_number": "561-740-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3836 W HILLSBORO BLVD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334429413",
            "telephone_number": "954-428-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSE-BRODZIAK",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "ACUPUNCTURIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP 1878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "C0986",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.