KATHLEEN L.S. BROADMAN (NPI# 1801909791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801909791 |
| Entity Type | Individual |
| Full Name | KATHLEEN L.S. BROADMAN |
| Credential | MD |
| Practice Address |
1080 Mount Bachelor Dr Bend OR 97702-3280 |
| Mailing Address |
1501 Ne Medical Center Dr Bend OR 97701-6051 |
| Practice Telephone | 5415504400 |
| Mailing Telephone | 5413822811 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2013-09-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD151194 | OR | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MD60079951 | WA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | ML20008665 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500622958 | 05 |
| Street Address |
1080 MOUNT BACHELOR DR |
| City | BEND |
| State | OR |
| Zip Code | 97702-3280 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124006689 | Dana M Rhode | Legal Medicine | 1080 Mount Bachelor Dr, Bend, OR 97702-3280 | 2006-01-05 |
| 1689800773 | Bend Memorial Clinic PC | Ophthalmology | 1080 Mount Bachelor Dr, Bend, OR 97702-3280 | 2009-06-03 |
| 1457513046 | Guitar Hanna | Pediatrics | 1080 Mount Bachelor Dr, Bend, OR 97702-3280 | 2008-06-25 |
| 1437279577 | Jennifer Blake Schroeder | Pediatrics | 1080 Mount Bachelor Dr, Bend, OR 97702-3280 | 2007-03-30 |
| 1104972710 | Michelle R Mills | Pediatrics | 1080 Mount Bachelor Dr, Bend, OR 97702-3280 | 2007-01-26 |
| 1265534242 | Cindy Anne Shuman | Physician Assistant | 1080 Mount Bachelor Dr, Bend, OR 97702-3280 | 2006-09-01 |
| 1215048715 | Jeffrey P Boggess | Family Medicine | 1080 Mount Bachelor Dr, Bend, OR 97702-3280 | 2006-08-31 |
| 1245343870 | Jennifer S. Griswold | Nurse Practitioner | 1080 Mount Bachelor Dr, Bend, OR 97702-3280 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962911347 | Bend Kids Pediatrics, LLC | Pediatrics | 2748 Nw Crossing Dr Ste 140, Bend, OR 97703-7179 | 2017-09-28 |
| 1326075516 | Dana D. Perryman | Pediatrics | 2200 Ne Professional Ct., Bend, OR 97701 | 2006-06-26 |
| 1992793988 | Jennifer G. Lachman | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2005-10-12 |
| 1104289073 | Heather Gardiner | Pediatrics | 2500 Ne Neff Rd, Bend, OR 97701-6015 | 2016-03-30 |
| 1629442298 | Erika Beard Irvine Md LLC | Pediatrics | 325 Nw Vermont St, Suite 105, Bend, OR 97703-1916 | 2015-11-19 |
| 1942695028 | Dana Elizabeth Honzel Angelos | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701-6063 | 2015-04-05 |
| 1811314040 | William Featherston Gilmore IIi | Pediatrics | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2014-03-26 |
| 1982048211 | Abby P. Hendricks | Pediatrics | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2013-04-17 |
| 1033475546 | Brenna Kathryn Lewis | Pediatrics | 2084 Ne Professional Ct, Bend, OR 97701 | 2012-04-09 |
| 1295050680 | Leslie Austin Rust | Pediatrics | 2200 Ne Professional Ct, Bend, OR 97701 | 2010-03-29 |
| Find all providers in BEND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.