Charlene Sue Broaddus, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4695P Issued in KY

Practice address

Gill Heart Institute 800 Rose St
G100
Lexington, KY 40536-0093

Phone

(859) 323-0295

Fax

(859) 257-8699

NPI assigned

Oct 18, 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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: qse7561@yourcarecommunity.org

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.

• Clark Regional Physician Practices LLC

  • Rural Health Clinic/Center
  • Mt Sterling, KY
  • NPI 1780356253
  Medicare reassignment NPD
• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment NPD
• Clark Regional Physician Practices, LLC

  • Durable Medical Equipment & Medical Supplies
  • Winchester, KY
  • NPI 1114282605
  NPD

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1780765735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 HOSPITAL DR",
            "address_2": "STE 300A",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403917604",
            "telephone_number": "859-323-3976",
            "fax_number": "859-257-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GILL HEART INSTITUTE 800 ROSE ST",
            "address_2": "G100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360093",
            "telephone_number": "859-323-0295",
            "fax_number": "859-257-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADDUS",
        "first_name": "CHARLENE",
        "middle_name": "SUE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "4695P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801709200",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Michael Brislin, B.PHARM.,RPH, FIAIHC
• Rita K Britt-Johnson, CADC, LSW
• Dawan Britt Jr.
• Jennifer L Broach, PH.D.
• Mary Benson Broadbent, APRN
• Austin Broadhead, MD
• Javonna Broadus
• John Douglas Broadus
• Marian Judith Broadus, PH. D.
• Broadway Clinic Pharmacy Inc

• Adult Health Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Adult Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.