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MALCOLM L BROADNAX
NPI 1457193278
Counselor - Addiction (Substance Use Disorder) in Nottingham, MD

Active since June 11, 2024PECOS Enrolled
4412 COLE FARM RD, NOTTINGHAM, MD 21236(443) 528-0822 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 11, 2025, Jun 4, 2025, Jun 11, 2024 (3 updates tracked since 2024).

About Malcolm L Broadnax NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALCOLM L BROADNAX (NPI 1457193278) is an individual addiction (substance use disorder) provider in Nottingham, Maryland, licensed in Maryland (LCA3486) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1457193278
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMALCOLM L BROADNAX
Location Address4412 COLE FARM RDNottingham, MD 21236-2961
Mailing Address2710 Pelham AveBaltimore, MD 21213-1119 · (443) 528-0822
Phone(443) 528-0822
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJune 11, 2024
Last NPPES UpdateJune 11, 20253 updates tracked since enumeration
NPPES CertifiedJune 11, 2025
✔ NPI 1457193278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in MD · LCA3486
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License LGP14898 (MD)
4412 COLE FARM RD, Nottingham, MD 21236
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Malcolm L Broadnax is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5597271551
PECOS Enrollment IDI20250821004390
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AWAKE & ROOTED WELLNESS & RECOVERY, LLC
Counselor (Addiction (Substance Use Disorder))
4412 COLE FARM RD
NOTTINGHAM, MD 21236
Baltimore County (443) 528-0822

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Malcolm Broadnax's NPI number?

The NPI number for Malcolm Broadnax is 1457193278. It was assigned to this individual provider in the NPPES registry on June 11, 2024.

Where is Malcolm Broadnax located?

Malcolm Broadnax practices at 4412 Cole Farm Rd, Nottingham, MD 21236. The listed phone number is (443) 528-0822.

What is Malcolm Broadnax's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Malcolm Broadnax enrolled in Medicare?

Yes. Malcolm Broadnax is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Malcolm Broadnax was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.