Active NPI
Erin Broadway, FNP
- Family Nurse Practitioner
- Milwaukee, WI
National Provider Identifier
1952998106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10494-33
- Practice address
- 10200 W Innovation Dr Ste 400
Milwaukee, WI 53226-4826 - Phone
- (414) 944-2038
- NPI assigned
- Dec 22, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10494-33 | WI | Primary |
Addresses
Primary practice location
10200 W Innovation Dr Ste 400
Milwaukee, WI 53226-4826
Mailing address
1110 N 119TH St
Wauwatosa, WI 53226-3304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210219002376 | WI | Practitioner - Nurse Practitioner | 7012322266 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1952998106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 N 119TH ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532263304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10200 W INNOVATION DR STE 400",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264826",
"telephone_number": "414-944-2038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADWAY",
"first_name": "ERIN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-22",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "10494-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.