Devery Gerard Broddie, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7291 Issued in OR

Practice address

315 Oak St. Ste 200
Hood River, OR 97031

Phone

(541) 386-0009

Fax

(541) 386-0029

NPI assigned

Jan 29, 2007

Last updated

Aug 31, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kidsense Inc

  dba Kidsense

  • Occupational Therapist
  • Hood River, OR
  • NPI 1902087901
  NPD (past)
• Kidsense Inc.

  dba Kidsense

  • Pediatric Physical Therapist
  • Hood River, OR
  • NPI 1992979272
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1972649903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 OAK ST, STE 200",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "97031",
            "telephone_number": "541-386-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 OAK ST. STE 200",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "97031",
            "telephone_number": "541-386-0009",
            "fax_number": "541-386-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODDIE",
        "first_name": "DEVERY",
        "middle_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "7291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dolly Ann Brandt, L.M.T
• James M Brauer, M.D.
• Julia Ruth Brennan, M.D.
• Virginia Brewster, MA
• Annette Marie Broddie, OTR/L
• Laura Lee Brown
• Tom H Brubaker, LCSW
• Bruce Alan Burton DMD PC
• Bruce J. Ruttenburg, PH.D., LLC
• Alexandria Victoria Bruce, OTR/L

• Massage Therapist in Hood River, OR
• Providers in Hood River, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.