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ST BROACH LLC
NPI 1477439511
Nurse Practitioner in Florence, SC

Active since August 13, 2025CLIA 42D2330499 · Waiver
908 S PARKER DR, FLORENCE, SC 29501(843) 260-8041 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About St Broach Llc NPPES

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

ST BROACH LLC (NPI 1477439511) is a healthcare organization registered as a nurse practitioner in Florence, South Carolina and active in the NPI registry since August 2025. The organization holds a CLIA Waiver certificate valid through September 16, 2027 and lists Tasha M Broach, Owner, as its authorized official.

NPPES Registry Identity

NPI1477439511
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameST BROACH LLC
Location Address908 S PARKER DRFlorence, SC 29501-6007
Mailing Address1841 Sloane LnFlorence, SC 29501-6532 · (843) 260-8041
Phone(843) 260-8041
Organization SubpartNo
Authorized OfficialTasha M BroachOwner · (843) 260-8041
Enumeration DateAugust 13, 2025
NPPES CertifiedAugust 13, 2025
✔ NPI 1477439511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
908 S PARKER DR, Florence, SC 29501
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2330499

St Broach LLC · Florence, SC
Active · expires Sep 16, 2027
CLIA Number42D2330499
Laboratory TypeIndependent
Certificate Effective DateSeptember 17, 2025
Certificate Expiration DateSeptember 16, 2027
Laboratory DirectorTasha M. Broach
Laboratory Phone(843) 260-8041
Laboratory LocationSt Broach LLC908 S Parker Drive, Florence, SC 29501
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

HELPING HEARTS, LLC
In Home Supportive Care
908 S PARKER DR, SUITE 3
FLORENCE, SC 29501
Florence County (843) 669-2999
SERENITY'S NEST LLC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
908 S PARKER DR
FLORENCE, SC 29501
Florence County (843) 917-1812
DEDICATED HOME CARE
Home Health
908 S PARKER DR
FLORENCE, SC 29501
Florence County (843) 409-6978
ALMETA'S TRANSPORTATION LLC.
Transportation Network Company
908 S PARKER DR
FLORENCE, SC 29501
Florence County (843) 917-1812
MS. MONICA LATOYA HOLLOWAY
Nurse Practitioner (Psychiatric/Mental Health)
908 S PARKER DR
FLORENCE, SC 29501
Florence County (843) 917-1812

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 St Broach LLC's NPI number?

The NPI number for St Broach LLC is 1477439511. It was assigned to this organization in the NPPES registry on August 13, 2025.

Where is St Broach LLC located?

St Broach LLC is located at 908 S Parker Dr, Florence, SC 29501. The listed phone number is (843) 260-8041.

What is St Broach LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does St Broach LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2330499) is associated with this NPI, valid through September 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for St Broach LLC was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.