Individual provider Active NPI

Candia Marie Broughton, APRN, FNP-C

  • Family Nurse Practitioner
  • Frankfort, KY
National Provider Identifier
1265916936
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3012693 Issued in KY
Practice address
4200 Lawrenceburg Rd
Frankfort, KY 40601-8936
Phone
(502) 227-4821
Fax
(502) 227-3013
NPI assigned
Sep 19, 2018
Last updated
May 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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 3012693 KY Primary

Addresses

Primary practice location

4200 Lawrenceburg Rd
Frankfort, KY 40601-8936

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 974-3447

Other practice location 1

60 Mack Walters Rd
Shelbyville, KY 40065-1738
Phone (502) 633-4622

Other practice location 2

601 S Hurstbourne Pkwy
Louisville, KY 40222-5081
Phone (502) 974-3447

Other identifiers 2

IdentifierTypeStateIssuer
3012693OtherKYAPRN
1084003OtherKYRN

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
I20190813000804 KY Practitioner - Nurse Practitioner 4688901788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stewart Home School IncGroup PAC ID 0941547608, 3 clinicians

Practice addresses (Care Compare)

4200 Lawrenceburg Rd
Frankfort, KY 40601-8415
Phone (502) 227-4821

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Aug 6, 2020 Accepting new patients
University of Louisville Physicians, Inc. Nurse Practitioner Current Accepting new patients
Stewart Home School Inc Family CurrentSince Jul 22, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Aug 6, 2020 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

4200 Lawrenceburg Rd
Frankfort, KY 40601
Phone (502) 219-7762

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

60 Mack Walters Rd
Shelbyville, KY 40065
Phone (502) 633-4622

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 3

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": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1265916936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-974-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 LAWRENCEBURG RD",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406018936",
            "telephone_number": "502-227-4821",
            "fax_number": "502-227-3013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Mack Walters Rd",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "KY",
            "postal_code": "400651738",
            "country_code": "US",
            "telephone_number": "502-633-4622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 S Hurstbourne Pkwy",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402225081",
            "country_code": "US",
            "telephone_number": "502-974-3447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "CANDIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "3012693",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "1084003",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, KY

Sources for this page

Verify at the official NPI Registry.