Individual provider Active NPI

Judy C Broughton, MN, FNP

  • Family Nurse Practitioner
  • Danville, VA
National Provider Identifier
1184624207
Registry record updated Nov 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024139541 Issued in VA
Practice address
705 Main St
Danville, VA 24541-1803
Phone
(434) 791-3630
Fax
(434) 791-4088
NPI assigned
Jul 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2013

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 0024139541 VA Primary

Addresses

Primary practice location

705 Main St
Danville, VA 24541-1803

Mailing address

4 S Main St
Chatham, VA 24531-5436
Phone (434) 791-3630

Other identifiers 1

IdentifierTypeStateIssuer
1184624207MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090812000704 VA Practitioner - Nurse Practitioner 9931253804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Access to Health Services, Inc CurrentSince Aug 4, 2009 Accepting new patients
Piedmont Access to Health Services, Inc Current Accepting new patients
Piedmont Access to Health Services, Inc CurrentSince Aug 4, 2009 Accepting new patients

Locations

4 S Main St
Chatham, VA 24531
Phone (434) 432-4443

705 Main St
Danville, VA 24541
Phone (434) 791-4122

Organizations & group practices 3

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383436800000",
    "number": "1184624207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S MAIN ST",
            "city": "CHATHAM",
            "state": "VA",
            "postal_code": "245315436",
            "telephone_number": "434-791-3630",
            "fax_number": "434-791-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MAIN ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411803",
            "telephone_number": "434-791-3630",
            "fax_number": "434-791-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "JUDY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "MN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2013-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024139541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184624207",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.