DR. KIMBERLY K BROUGHTON (NPI# 1629208210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629208210 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY K BROUGHTON |
| Credential | M.D. |
| Practice Address |
307 Boatner Rd Ste 114 Eglin Afb FL 32542-1302 |
| Practice Telephone | 8508838600 |
| Mailing Telephone | 8508838600 |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2020-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 279303 | MA | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 47474 | CO | Allopathic & Osteopathic Physicians |
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
ME120354 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619479177 | Kimberly E Broughton | Physical Therapist | 6480 Harrison Ave, Cincinnati, OH 45247-7961 | 2018-03-01 |
| 1164640074 | Kimberly Jo Broughton | Counselor | 1203 American Greeting Rd, Corbin, KY 40701-4811 | 2007-04-23 |
| Street Address |
307 BOATNER RD STE 114 |
| City | EGLIN AFB |
| State | FL |
| Zip Code | 32542-1302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134111453 | Thomas James Cantilina | Family Medicine | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2005-08-23 |
| 1861009466 | Patricia Allison Kellogg | Dietitian, Registered | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2020-09-28 |
| 1396367389 | Matthew Christopher Little | Student in an Organized Health Care Education/Training Program | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2020-05-12 |
| 1750916961 | Joseph Roland Adamson | Student in an Organized Health Care Education/Training Program | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2020-03-08 |
| 1447885181 | Deserea Marie Shoemaker | Student in an Organized Health Care Education/Training Program | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1282 | 2020-03-03 |
| 1457985764 | Anaya Baeza | Nurse Practitioner | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2020-02-25 |
| 1043853435 | Sandra K Hoffa | Social Worker | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2019-10-18 |
| 1861042624 | Amy W Snow | Pharmacist | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2019-09-13 |
| 1760042501 | Alison Natalie Snyder | Student in an Organized Health Care Education/Training Program | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2019-06-14 |
| 1689237232 | Clint Copeland | Physical Therapist | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2019-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417440306 | Colt Sicher | Student in an Organized Health Care Education/Training Program | 96th Dental Squadron (afmc), Eglin Afb, Fl 32542, Apo, AA 32542 | 2018-06-14 |
| 1841679529 | Matthew Scurria | Dentist | 340 Boatner Rd. Bldg 2751, 96 Dental Squadron/sgdr, Eglin Afb, FL 32542 | 2015-05-27 |
| 1134518798 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 | 2015-01-20 |
| 1598177123 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 | 2014-06-02 |
| 1548602923 | Gerald Jordan Novack | Psychologist | 96mdos/sgow, 307 Boatner Rd, Fpo, AP 32542 | 2013-07-25 |
| 1699112821 | Taylor Anne Hahn | Obstetrics & Gynecology | 96th Medical Group, 307 Boatner Road, Eglin Air Force Base, FL 32542 | 2013-05-29 |
| 1730456948 | Nicholas Brandon Sager | Dentist | 340 Boatner Rd, Eglin Afb, Apo, AA 32542 | 2011-11-17 |
| 1134402662 | Jessamy Jae Thornton | Student in an Organized Health Care Education/Training Program | 340 Boatner Rd, Bldg 2751, Eglin Afb, FL 32542 | 2011-09-21 |
| 1346523974 | Mary Elizabeth Sorrentino | Dentist | 340 Boatner Road, Blgd. 2751, Eglin Afb, FL 32542 | 2011-09-20 |
| 1588945612 | Martin Army Community Hospital | Clinic/Center | 4327 North El Salvador Way, Eglin Afb, FL 32542 | 2011-09-02 |
| Find all providers in zip 32542 | ||||
| Taxonomy Code | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891220828 | Hill Orthopedic Center LLC | Orthopaedic Surgery | 540 S Chickasaw Trl, Orlando, FL 32825-7804 | 2017-04-27 |
| 1962898106 | Kshitij Manchanda | Orthopaedic Surgery | 1150 Campo Sano Ave, 2nd Floor, Attn: Maria Claudia Corrandine, Coral Gables, FL 33146 | 2015-04-14 |
| 1679511174 | Sophia Esther Deben | Orthopaedic Surgery | 20601 E. Dixie Hwy, Orthopaedic Specialists of Miami Beach, Aventura, FL 33180 | 2006-06-04 |
| 1427005081 | Thomas E Odmark | Orthopaedic Surgery | 12416 66th Street N, Suite A, Largo, FL 33773-3437 | 2006-05-28 |
| 1740244243 | Mark S Mizel | Orthopaedic Surgery | 1121 Crandon Blvd Apt F403, Key Biscayne, FL 33149-2779 | 2006-04-13 |
| 1346217635 | Kevin B Newfield | Orthopaedic Surgery | 103 Coco Plum Dr, Marathon, FL 33050-4016 | 2006-03-05 |
| 1124090501 | Stanley S Shama | Orthopaedic Surgery | 232 Bullard Pkwy, Temple Terrace, FL 33617-5512 | 2006-02-01 |
| 1255330288 | Myles Rubin Samotin | Orthopaedic Surgery | 870 111th Ave N, Naples, FL 34108-1869 | 2005-07-20 |
| 1669478038 | Pierre Girard | Orthopaedic Surgery | 621 Se Port St Lucie Blvd, Port St Lucie, FL 34984-5141 | 2005-06-22 |
| 1316507239 | Wigley Feet | Orthopaedic Surgery | 1595 Ne 163rd St, North Miami Beach, FL 33162-4717 | 2019-06-13 |
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| 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.