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

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

Other identifiers 1

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 and National Provider Directory roles.

• Kidsense Inc

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

  • 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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972649903",
            "state": "OR"
        }
    ],
    "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.