Individual provider Active NPI

John E Broadbent, M.D.

  • Specialist
  • Murray, KY
National Provider Identifier
1902894983
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
29485 Issued in KY
Practice address
300 S 8TH St
Ste 182W
Murray, KY 42071-2400
Phone
(270) 762-1560
Fax
(270) 752-2861
NPI assigned
Oct 12, 2005
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 29485 KY Primary

Addresses

Primary practice location

300 S 8TH St
Ste 182W
Murray, KY 42071-2400

Mailing address

300 S 8TH St
Ste 480W
Murray, KY 42071-2400
Phone (270) 762-1560

Other identifiers 4

IdentifierTypeStateIssuer
5196668OtherKYAETNA
000000215823OtherKYBLUE CROSS BLUE SHIELD
64294853MedicaidKY
2500783OtherKYUNITED HEALTH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050307000164 KY Practitioner - Cardiovascular Disease (Cardiology) 3577517234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Louisville School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trigg County Hospital, IncGroup PAC ID 5193620805, 33 clinicians

Practice addresses (Care Compare)

214 Main St
Cadiz, KY 42211-9153
Phone (270) 522-0898

254 Main St
Cadiz, KY 42211-9153
Phone (270) 522-3215

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Trigg County Hospital, Inc CurrentSince Jun 3, 2020 Accepting new patients
Trigg County Hospital, Inc CurrentSince Jun 3, 2020 Accepting new patients

Locations

214 Main St
Cadiz, KY 42211
Phone (270) 522-0898

250 Main St
Ste B
Cadiz, KY 42211

254 Main St
Cadiz, KY 42211
Phone (270) 522-3215

Interoperability endpoints

  • Direct secure messaging: john.broadbent@tcpc.eclinicaldirectplus.com

Organizations & group practices 2

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1902894983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S 8TH ST",
            "address_2": "STE 480W",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712400",
            "telephone_number": "270-762-1560",
            "fax_number": "270-752-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 8TH ST",
            "address_2": "STE 182W",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712400",
            "telephone_number": "270-762-1560",
            "fax_number": "270-752-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADBENT",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "29485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5196668",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000215823",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64294853",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "2500783",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

Verify at the official NPI Registry.