Individual provider Active NPI

Patricia G Broughton, ARNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Covington, KY
National Provider Identifier
1174766489
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3006016 Issued in KY
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

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
7100074300MedicaidKY

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
I20090519000632 KY Practitioner - Nurse Practitioner 8628127784 Reassigns benefits to 1 organization

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
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

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

LicenseStateTypeSpecialty
3006016KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC CurrentSince Jun 23, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.