Jeremy Broussard, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1741 Issued in LA

Practice address

612 Rue de Onetta
New Iberia, LA 70563-2163

Phone

(337) 367-6649

NPI assigned

May 12, 2015

Last updated

May 12, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bryant Medical Group LLC

  • General Practice Physician
  • New Iberia, LA
  • NPI 1184112450
  Medicare reassignment NPD
• Dickinson Chiropractic LLC

  • Clinic/Center
  • Denham Springs, LA
  • NPI 1083338206
  Medicare reassignment NPD
• Virgil Bryant Management

  • Chiropractor
  • New Iberia, LA
  • NPI 1609186626
  Medicare reassignment NPD
• Theriot Family Chiropractic Center

  • Chiropractor
  • New Iberia, LA
  • NPI 1902067457
  NPD (past)
• Total Care Medical Center of Southeast Louisiana, Inc.

  • Chiropractor
  • Donaldsonville, LA
  • NPI 1881839876
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1003294919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 RUE DE ONETTA",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "70563",
            "telephone_number": "337-367-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 RUE DE ONETTA",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632163",
            "telephone_number": "337-367-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ajah Broussard
• Carlos A Broussard, CRNA
• Gerald Broussard, R.P.H.
• Harold Joseph Broussard, PA
• James R Broussard, LCSW
• Julie Broussard, RPH
• Lena Broussard
• Magan Broussard
• Paul W Broussard, CRNA
• Broussards Pharmacy of New Iberia Inc (Broussards Pharmacy)

• Chiropractor in New Iberia, LA
• Providers in New Iberia, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.