CLYDENA JEAN BROUGHTON FNP - C
NPI 1588979314
Nurse Practitioner - Psychiatric/Mental Health in Nitro, WV

Q: What is Clydena Broughton's NPI number?

The NPI number for Clydena Broughton is 1588979314. It was assigned to this individual provider in the NPPES registry on August 17, 2010.

Q: What is Clydena Broughton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Clydena Broughton was last updated on October 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 17, 2010PECOS EnrolledAccepts Medicare Assignment

4111 1ST AVE STE 3, NITRO, WV 25143(304) 755-4797(304) 755-4799 Get Directions Write a Review

NPPES record last updated: October 16, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 1, 2023, Jul 5, 2022, Dec 17, 2015 (3 updates tracked since 2015).

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About Clydena Jean Broughton Fnp - C NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLYDENA JEAN BROUGHTON FNP - C (NPI 1588979314) is an individual psychiatric/mental health provider in Nitro, West Virginia, licensed in West Virginia (62736) and active in the NPI registry since August 2010. She is enrolled in Medicare PECOS, is affiliated with Charleston Area Medical Center, and maintains a secondary practice location in Cross Lanes.

NPPES Registry Identity

NPI1588979314

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameCLYDENA JEAN BROUGHTONCredential: FNP - C

Location Address4111 1ST AVE STE 3Nitro, WV 25143-1345

Mailing Address140 Hickory Rd # 4Charleston, WV 25314-1824 · (304) 752-1669

Phone(304) 755-4797

Fax(304) 755-4799

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateAugust 17, 2010

Last NPPES UpdateOctober 16, 20243 updates tracked since enumeration

NPPES CertifiedOctober 16, 2024

✔ NPI 1588979314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in WV · 62736

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License APRN62736-NP-C (WV), 0024183957 (VA)

4111 1ST AVE STE 3, Nitro, WV 25143

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Secondary Practice Location 1

Location 1314 Goff Mountain RdCross Lanes, WV 25313-6602 · Phone (304) 388-7070

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Clydena Jean Broughton Fnp - C is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698963940

PECOS Enrollment IDI20101230000623

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Clydena Broughton reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pulmonary Associates Of Char LLC

8.0 mi

Pulmonary Disease

4619 KANAWHA AVE., SW
South Charleston, WV 25309

Reassigned Medicare billing, West Virginia enrollment
25 clinicians in this Medicare group

NPI 1114124799 (304) 400-4545

Charleston Area Medical Center, Inc.

13 mi

General Acute Care Hospital

501 MORRIS ST
Charleston, WV 25301

Reassigned Medicare billing, West Virginia enrollment
1,511 clinicians in this Medicare group

NPI 1124248752 (304) 388-3939

East Mountain Health Physicians, Inc.

151 mi

Family Medicine

100 HOSPITAL DR STE 1
Petersburg, WV 26847

Reassigned Medicare billing, West Virginia enrollment
135 clinicians in this Medicare group

NPI 1093219628 (304) 257-1944

Valley Regional Enterprises, Inc

193 mi

Urgent Care

33820 OLD VALLEY PIKE, SUITE 2
Strasburg, VA 22657

Reassigned Medicare billing, Virginia enrollment
77 clinicians in this Medicare group

NPI 1063666196 (540) 536-2221

Greenbrier Emergency Services, Inc.

Reassigned Medicare billing, West Virginia enrollment
207 clinicians in this Medicare group

No phone listed

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

61 services61 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Charleston Area Medical Center

Acute Care Hospitals · Charleston, WV

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510022

Location501 Morris StreetCharleston, WV 25301 · Kanawha County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25143 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.49 typical visit price

range $53.20 – $164.59

Typical copayment $20.87 (range $13.30 – $41.14)

Most-billed visit code 99203

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

5 suppliers33 claims5,810 services$1.54 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH ZACHARY WILEY MD

Family Medicine