SAMANTHA BROUGHTON


Address: 10010 Kennerly Rd, Saint Louis, MO 63128-2106
Phone: 3145251000

SAMANTHA BROUGHTON (NPI# 1881215424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881215424
Entity Type Individual
Full Name SAMANTHA BROUGHTON
Practice Address 10010 Kennerly Rd
Saint Louis
MO 63128-2106
Mailing Address 1034 Sherbrooke Rd
Saint Charles
MO 63303-4027
Practice Telephone 3145251000
Mailing Telephone 3142671363
Enumeration Date 2020-05-06
Last Update Date 2020-05-06
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 2020011684 MO Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1034 Sherbrooke Rd, Saint Charles, MO 633034027 3142671363

Other Providers SAMANTHA BROUGHTON

NPI Name Taxonomy Address Enumeration
1700447315 Samantha Marie Broughton Nurse Practitioner 201 Plaza Dr Ste A, Sikeston, MO 63801-5110 2019-06-25

Office Location

Street Address 10010 KENNERLY RD
City SAINT LOUIS
State MO
Zip Code 63128-2106

Providers in the same location

NPI Name Taxonomy Address Enumeration
1659374908 Udayshanker Kasinadhuni Anesthesiology 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2005-05-31
1598376287 Laura Mayer Dietitian, Registered 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2020-08-14
1265042014 Caitlin E Wagner Anesthesiologist Assistant 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2020-08-06
1437779444 Kathleen Stebe Physical Therapist 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2020-04-20
1073148052 Carly Pruemer Nurse Anesthetist, Certified Registered 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2020-03-10
1568097541 Altan Halici Nurse Anesthetist, Certified Registered 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2020-03-10
1326673310 Rhyz Wilson Nurse Anesthetist, Certified Registered 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2020-03-10
1669007654 Megan Hahn Nurse Anesthetist, Certified Registered 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2020-03-10
1851925085 Katie Walsh Nurse Practitioner 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2020-02-26
1558912824 Kristy Marie Dehne Nurse Practitioner 10010 Kennerly Rd, Saint Louis, MO 63128-2106 2019-09-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235771155 James T Fetsch Dmd LLC Dentist 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 2019-10-11
1326504655 Nikodem Dental Holdings Dentist 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 2019-02-12
1932678505 Michelle Anne Arvidson Physical Therapy Assistant Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 2018-11-13
1245726710 Kristen Rider Nurse Practitioner 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 2018-07-07
1306217427 Sophia Bednarski Dentist 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 2015-10-15
1427434224 Darcie Burrus Counselor 12523 Old Tesson Rd G, St Louis, MO 63128 2015-08-04
1710368584 Sara Hawatmeh Internal Medicine 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 2015-06-17
1871989590 Celia Grace Montes-kolence Speech-Language Pathologist 12335 W Bend Drive, Saint Louis, MO 63128 2015-04-09
1245629302 Marius Antonio Evans Dentist 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 2015-01-13
1801230313 Sarah Elizabeth Walsh Emergency Medicine 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 2013-04-26
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1184221160 Zachary Wade Orr Nurse Practitioner 1622 S 18th St, Saint Louis, MO 63104-2504 2020-10-02
1073128518 Christen Rincker Nurse Practitioner 2343 Hickory St, Saint Louis, MO 63104-2418 2020-09-11
1861026650 Kelly Ann Clark Nurse Practitioner 4590 Childrens Pl, Saint Louis, MO 63110-1020 2020-03-02
1902444292 Tony Duy Le Nurse Practitioner 1251 Hyannis Dr, Saint Louis, MO 63146-4639 2019-12-17
1114562154 Lisa Pezold Nurse Practitioner 2029 Woodland Pkwy, Saint Louis, MO 63146-4267 2019-11-13
1255806527 Rachel Ramos Nurse Practitioner 11133 Dunn Rd Ste 209e, Saint Louis, MO 63136-6163 2018-10-12
1851893341 Jessica Rae Britt Nurse Practitioner 1 Barnes Jewish Hospital Plz Fl 10, 10th Fl, Saint Louis, MO 63110-1003 2018-03-01
1952816449 Loreta Shahinaj Nurse Practitioner 12700 Southfork Rd Ste 270, Saint Louis, MO 63128-3201 2017-12-06
1689183832 Natalie Michelle Barone Nurse Practitioner 3023 N Ballas Rd Ste 630, Saint Louis, MO 63131-2361 2017-09-20
1194240986 Laura Kaesser Nurse Practitioner 11125 Dunn Rd Ste 204, Saint Louis, MO 63136-6188 2017-08-14
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Competitor

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City SAINT LOUIS
Zip Code 63128

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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