Individual provider Active NPI

Kimberly Dana Broughton-Miller, ARNP, MSN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1174657415
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5132P Issued in KY
Practice address
200 Abraham Flexner Way
Louisville, KY 40202-2877
Phone
(502) 587-4421
Fax
(502) 587-4840
NPI assigned
Mar 16, 2007
Last updated
Apr 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5132P KY Primary

Addresses

Primary practice location

200 Abraham Flexner Way
Louisville, KY 40202-2877

Mailing address

5454 New Cut Rd
Suite 5
Louisville, KY 40214-4271
Phone (502) 361-9900

Other identifiers 1

IdentifierTypeStateIssuer
7100159710MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20080619000407 KY Practitioner - Nurse Practitioner 8022189950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 562-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
5132PKYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2020 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2020 Accepting new patients
University of Louisville Physicians Inc. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

200 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 569-7983

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

1903 W Hebron Ln
Shepherdsvlle, KY 40165
Phone (502) 587-4421

Organizations & group practices 4

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1174657415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 NEW CUT RD",
            "address_2": "SUITE 5",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402144271",
            "telephone_number": "502-361-9900",
            "fax_number": "502-361-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ABRAHAM FLEXNER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022877",
            "telephone_number": "502-587-4421",
            "fax_number": "502-587-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON-MILLER",
        "first_name": "KIMBERLY",
        "middle_name": "DANA",
        "name_prefix": "Ms.",
        "credential": "ARNP, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "5132P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100159710",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.