Marian Judith Broadus, PH. D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

834 Issued in KY

Practice address

436 W 2ND St
Lexington, KY 40507-1040

Phone

(859) 231-7137

Fax

(859) 253-0098

NPI assigned

Apr 24, 2006

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

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194781765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 W 2ND ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405071040",
            "telephone_number": "859-231-7137",
            "fax_number": "859-253-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 W 2ND ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405071040",
            "telephone_number": "859-231-7137",
            "fax_number": "859-253-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADUS",
        "first_name": "MARIAN",
        "middle_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Benson Broadbent, APRN
• Charlene Sue Broaddus, ARNP
• Austin Broadhead, MD
• Javonna Broadus
• John Douglas Broadus
• Broadway Clinic Pharmacy Inc
• Broadway Denture Center
• Broadway Family and Cosmetic Dentistry PSC
• Jennifer Brocato, ARNP
• Jenna Rose Brock, MA, BCBA, LBA

• Psychologist in Lexington, KY
• Providers in Lexington, KY by specialty
• Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.