Individual provider Active NPI

Tonya M Broughton, APRN, FNP-BC

  • Family Nurse Practitioner
  • Charlestown, IN
National Provider Identifier
1902202641
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71005212A Issued in IN
Practice address
1454 Market St
Charlestown, IN 47111-1839
Phone
(812) 503-5071
Fax
(812) 503-5076
NPI assigned
Nov 7, 2014
Last updated
Jul 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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 71005212A IN Primary

Addresses

Primary practice location

1454 Market St
Charlestown, IN 47111-1839

Mailing address

1454 Market St
Charlestown, IN 47111-1839
Phone (812) 503-5071

Other identifiers 1

IdentifierTypeStateIssuer
201267300MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20141215000352 IN Practitioner - Nurse Practitioner 9638491087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hoke MedicalGroup PAC ID 6204170038, 3 clinicians

Practice addresses (Care Compare)

1454 Market St
Charlestown, IN 47111-1839
Phone (812) 503-5071

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hoke Medical CurrentSince Jan 6, 2020 Accepting new patients

Locations

1454 Market St
Charlestown, IN 47111
Phone (812) 503-5071

12803 Lenover St
Dillsboro, IN 47018
Phone (812) 432-5226

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.

Hospital & facility affiliations 2

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": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1902202641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 MARKET ST",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471111839",
            "telephone_number": "812-503-5071",
            "fax_number": "812-503-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 MARKET ST",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471111839",
            "telephone_number": "812-503-5071",
            "fax_number": "812-503-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "TONYA",
        "middle_name": "M",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-07",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005212A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201267300",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, IN

Sources for this page

Verify at the official NPI Registry.