Active NPI
Patricia G Broughton, ARNP, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Covington, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 3006016
- Practice address
- 1401 Madison Ave
Covington, KY 41011-3313 - Phone
- (859) 655-6100
- NPI assigned
- Apr 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3006016 | KY | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3006016 | KY | Primary |
Addresses
Primary practice location
1401 Madison Ave
Covington, KY 41011-3313
Mailing address
215 E 11TH St
Newport, KY 41071-2203
Phone (859) 655-6100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100074300 | Medicaid | KY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1255 Providence LN
Suite 115
Lexington, KY 40502-2380
Phone (216) 468-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3006016 | KY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological & Behavioral Consultants, LLC | Current | Accepting new patients | |
| Appalachian Regional Healthcare, Inc. | Nurse Practitioner | Past | Accepting new patients |
Locations
250 Grandview Dr
Ste 575
Ft Mitchell, KY 41017
Phone (317) 292-7108
1255 Providence Place Pkwy
Ste 115
Lexington, KY 40511
Phone (859) 214-7440
100 Executive Park
Ste 103
Louisville, KY 40207
Phone (502) 313-6880
Interoperability endpoints
- lifestancehealth.patriciabroughton@140103.advancedmd-direct.com
Organizations & group practices 2
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.
-
- Clinical Pathology/Laboratory Medicine Physician
- Whitesburg, KY
- NPI 1417045998
Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1174766489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 E 11TH ST",
"city": "NEWPORT",
"state": "KY",
"postal_code": "410712203",
"telephone_number": "859-655-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 MADISON AVE",
"city": "COVINGTON",
"state": "KY",
"postal_code": "410113313",
"telephone_number": "859-655-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUGHTON",
"first_name": "PATRICIA",
"middle_name": "G",
"credential": "ARNP, PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-16",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3006016",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "KY",
"license": "3006016",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100074300",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Covington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.