MR. BRODERIC D IVERY
NPI 1972844553
Rehabilitation Practitioner in North Las Vegas, NV

Q: What is Broderic Ivery's NPI number?

The NPI number for Broderic Ivery is 1972844553. It was assigned to this individual provider in the NPPES registry on March 7, 2013.

Q: What is Broderic Ivery's specialty?

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

Q: When was this NPI record last updated?

The NPPES record for Broderic Ivery was last updated on March 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 March 07, 2013

1915 ONA MARIE AVE, NORTH LAS VEGAS, NV 89032(702) 812-4973(702) 631-6312 Get Directions Write a Review

NPPES record last updated: March 7, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Broderic D Ivery NPPES

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

MR. BRODERIC D IVERY (NPI 1972844553) is an individual rehabilitation practitioner in North Las Vegas, Nevada and active in the NPI registry since March 2013.

NPPES Registry Identity

NPI1972844553

Entity TypeIndividualMale

Primary Taxonomy225400000X

Provider Legal NameMR. BRODERIC D IVERY

Location Address1915 ONA MARIE AVENorth Las Vegas, NV 89032-4866

Mailing Address1915 Ona Marie AveNorth Las Vegas, NV 89032-4866 · (702) 812-4973 · Fax (702) 631-6312

Phone(702) 812-4973

Fax(702) 631-6312

Sole ProprietorYes

Enumeration DateMarch 7, 2013

✔ NPI 1972844553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code225400000X

Definition

A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

1915 ONA MARIE AVE, North Las Vegas, NV 89032

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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 Broderic Ivery's NPI number?

The NPI number for Broderic Ivery is 1972844553. It was assigned to this individual provider in the NPPES registry on March 7, 2013.

Where is Broderic Ivery located?

Broderic Ivery practices at 1915 Ona Marie Ave, North Las Vegas, NV 89032. The listed phone number is (702) 812-4973.

What is Broderic Ivery's specialty?

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

When was this NPI record last updated?

The NPPES record for Broderic Ivery was last updated on March 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.