Lucy Broaddus, MMS, PA-C, ATC.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004281 Issued in IL

Practice address

310 N 7 Hills Rd Ste 220
O Fallon, IL 62269-4111

Phone

(618) 624-6181

NPI assigned

Feb 1, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Lucy Elliott Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment Care Compare group NPD
• Granite City Clinic Corp

  • Certified Registered Nurse Anesthetist
  • Granite City, IL
  • NPI 1003892464
  NPD (past)
• Granite City Physicians Corp

  • Clinical Medical Laboratory
  • Granite City, IL
  • NPI 1508983214
  NPD (past)
• Old Six Mile Inpatient Services, LLC

  • Internal Medicine Physician
  • Granite City, IL
  • NPI 1285060665
  NPD (past)
• PC Associates, LLC

  • Family Medicine Physician
  • Dupo, IL
  • NPI 1437462637
  NPD (past)
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  • General Acute Care Hospital
  • O Fallon, IL
  • NPI 1629057302
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1114299419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N 7 HILLS RD STE 220",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622694111",
            "telephone_number": "618-624-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N 7 HILLS RD STE 220",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622694111",
            "telephone_number": "618-624-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADDUS",
        "first_name": "LUCY",
        "name_prefix": "Ms.",
        "credential": "MMS, PA-C, ATC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "310 N 7 Hills Rd Ste 220",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622694111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LUCY",
            "last_name": "ELLIOTT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Marie Brauer, DMD
• Alexzandra Brawley
• Gregory Bray-Stanley, MD
• Luke Brechner
• Katherine E Bridgman
• Skyla Latrice Brockman
• Jasmine Tiara Brooks
• Demetra Brown
• Janya Auonya Brown
• Kaylon Xavier Brown, RBT

• Physician Assistant in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.