Anne C Broderson, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-2600 Issued in HI

Practice address

75-5699 Kopiko St Unit 5
Kailua Kona, HI 96740-3651

Phone

(808) 215-6574

Fax

(808) 758-0043

NPI assigned

Jan 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: anne.broderson@hawaiihie.medicity.net
• Direct secure messaging: anne.broderson@652760900960260.direct.elationemr.com

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.

• Alii Health Center

  • Urology Physician
  • Kailua Kona, HI
  • NPI 1225620321
  NPD (past)
• Hogan and Broderson Chiropractic

  dba Malama Chiropractic Clinic

  • Chiropractor
  • Kailua Kona, HI
  • NPI 1255483954
  NPD (past)

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732924800000",
    "number": "1992269534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 286",
            "city": "HOLUALOA",
            "state": "HI",
            "postal_code": "967250286",
            "telephone_number": "808-215-6574",
            "fax_number": "808-758-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5699 KOPIKO ST UNIT 5",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403651",
            "telephone_number": "808-215-6574",
            "fax_number": "808-758-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERSON",
        "first_name": "ANNE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "RN-63490",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-2600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "830689",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Braun
• Aiko Joy Bray, MT
• Cassandra Briggs
• Peggy Brisbane, LMT
• Lisa Ann Brittain, M.S.
• Jennifer Diane Broderson, L.M.T.
• Jesse Broderson, D.C.
• Shannon Marie Broderson, D.C.
• Dennis Brody
• Sharon Brown Guillermo, LMT

• Family Nurse Practitioner in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Family Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.