DEAN CARL BROOME, M.D, — NPI 1356548002 (Licensed & Credentialed Legal Medicine in BLACKSHEAR, GA)

CMS-1500 Box 24J / 33a • NPI

1356548002

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

209800000X

Licensed & Credentialed Legal Medicine

Box 32 Service Location & ZIP+4

115 MAIN ST, BLACKSHEAR, GA, 31516-0271

✓ 9-Digit EDI 837 ZIP+4 (31516-0271)

Practice Phone & Referral Fax

(912) 449-1477

Fax: (912) 449-1479

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1356548002 (DEAN CARL BROOME, M.D,) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1356548002` (NPI-1 Individual Practitioner)
Provider / Legal Name	DEAN CARL BROOME, M.D,
Plain-English Specialty	Licensed & Credentialed Legal Medicine NUCC Code: `209800000X` (Legal Medicine)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	115 MAIN ST, BLACKSHEAR, GA, 31516-0271
Practice Telephone / Fax	Tel: (912) 449-1477 \| Fax: (912) 449-1479
Administrative Mailing Address	115 MAIN ST, BLACKSHEAR, GA, 31516-0271
Enumeration & Last Sync	Enumerated: 2007-06-27 \| CMS Record Updated: 2025-09-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

115 MAIN ST, BLACKSHEAR, GA, 31516-0271

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Plain-English Taxonomy & CMS Crosswalk (209800000X)

What Does Taxonomy Code 209800000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 209800000X translates to:
"Licensed & Credentialed Legal Medicine"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Legal Medicine for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DEAN CARL BROOME, M.D,)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207R00000X` — Internal Medicine Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: GA \| License: `048604` \| Primary: Secondary
`208000000X` — Pediatrics Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: GA \| License: `048604` \| Primary: Secondary
`2080A0000X` — Pediatrics, Adolescent Medicine Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: GA \| License: `048604` \| Primary: Secondary
`2080P0205X` — Pediatrics, Pediatric Endocrinology Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: GA \| License: `048604` \| Primary: Secondary
`209800000X` — Legal Medicine Plain English: Licensed & Credentialed Legal Medicine	State: GA \| License: `048604` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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DEAN CARL BROOME, M.D, (NPI #1356548002)