EDWIN CHARLES BROADNAX
NPI 1518248640
Social Worker - School in Riverside, CA

Q: What is Edwin Broadnax's NPI number?

The NPI number for Edwin Broadnax is 1518248640. It was assigned to this individual provider in the NPPES registry on September 2, 2011.

Q: What is Edwin Broadnax's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in School, with taxonomy code 1041S0200X.

Q: When was this NPI record last updated?

The NPPES record for Edwin Broadnax was last updated on September 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.

Active since September 02, 2011PECOS Enrolled

3801 UNIVERSITY AVENUE, SUITE 400, RIVERSIDE, CA 92501(951) 955-7108 Get Directions Write a Review

NPPES record last updated: September 2, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Edwin Charles Broadnax NPPES

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

EDWIN CHARLES BROADNAX (NPI 1518248640) is an individual school provider in Riverside, California, licensed in California (104100000X) and active in the NPI registry since September 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1518248640

Entity TypeIndividualMale

Primary Taxonomy1041S0200X

Provider Legal NameEDWIN CHARLES BROADNAX

Location Address3801 UNIVERSITY AVENUE, SUITE 400Riverside, CA 92501

Mailing Address3801 University Avenue, Suite 400Riverside, CA 92501 · (951) 955-7108

Phone(951) 955-7108

Sole ProprietorYes

Enumeration DateSeptember 2, 2011

✔ NPI 1518248640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · SchoolBehavioral Health & Social Service Providers

Taxonomy Code1041S0200X

License✔ Licensed in CA · 104100000X

3801 UNIVERSITY AVENUE, SUITE 400, Riverside, CA 92501

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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)

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

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.

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 Edwin Broadnax's NPI number?

The NPI number for Edwin Broadnax is 1518248640. It was assigned to this individual provider in the NPPES registry on September 2, 2011.

Where is Edwin Broadnax located?

Edwin Broadnax practices at 3801 University Avenue, Suite 400, Riverside, CA 92501. The listed phone number is (951) 955-7108.

What is Edwin Broadnax's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in School, with taxonomy code 1041S0200X.

Is Edwin Broadnax enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Edwin Broadnax was last updated on September 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.