Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jamilah Aisha Broderick, PA-C

Individual provider Physician Assistant · NPI 1033873294

Jamilah Aisha Broderick, PA-C is a Physician Assistant in Durham, North Carolina. Qualified in 2021, 5 years ago. Practices with Animo Sano Psychiatry PLLC, a 47-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
5
Licensed in
NC
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone: (919) 391-7202
Fax: (919) 391-7203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 280 Executive Park Dr Ste 100, Concord, NC 28025-1838 — (336) 370-5240

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-11519 (NC)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1033873294
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 25, 2021
Last updated in NPPESJanuary 30, 2025
Certification dateJanuary 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Animo Sano Psychiatry Pllc — 47 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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