Individual provider Active NPI

Susan C. Broughton, APRN, CNS

  • Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
  • New Bedford, MA
National Provider Identifier
1336169549
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0807X
License
121578 Issued in MA
Practice address
50 North Second St
New Bedford, MA 02740
Phone
(508) 993-1377
Fax
(508) 999-7795
NPI assigned
Jul 20, 2006
Last updated
Feb 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X 121578 MA Primary

Addresses

Primary practice location

50 North Second St
New Bedford, MA 02740

Mailing address

151 Rock St
Fall River, MA 02720-3201
Phone (508) 678-7542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050908000557 MA Practitioner - Certified Clinical Nurse Specialist (CNS) 3274565437 Reassigns benefits to 1 organization
Practice locations: New Bedford, MA

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Boston University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

106 Spring St
New Bedford, MA 02740-5951
Phone (508) 817-7955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
121578MAMDChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Association of Greater Fall River, Inc. Psychiatric/Mental Health, Child & Adolescent CurrentSince Aug 3, 2016 Accepting new patients

Locations

101 Rock St
Fall River, MA 02720
Phone (508) 677-3822

151 Rock St
Fall River, MA 02720
Phone (508) 678-7542

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1336169549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 ROCK ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203201",
            "telephone_number": "508-678-7542",
            "fax_number": "508-676-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NORTH SECOND ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "02740",
            "telephone_number": "508-993-1377",
            "fax_number": "508-999-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "SUSAN",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "APRN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MA",
            "license": "121578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.