John Joseph Broussard

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

09615 Issued in LA

Practice address

2115 Dulles Dr
Lafayette, LA 70506-2652

Phone

(337) 981-9182

Fax

(337) 988-3441

NPI assigned

May 4, 2017

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

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MTS-LGH Therapy Services LLCGroup PAC ID 1052683174, 29 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• MTS-LGH Therapy Services LLC

  • Physical Therapist
  • Lafayette, LA
  • NPI 1972024081
  Medicare reassignment Care Compare group NPD
• PT Pros, Inc.

  • Physical Therapist
  • Lafayette, LA
  • NPI 1164153839
  Medicare reassignment NPD
• John Broussard Enterprises LLC

  • Physical Therapy Clinic/Center
  • Lafayette, LA
  • NPI 1518530401
  NPD Authorized official
• Acadiana Physical Therapy, Inc.

  • Physical Therapist
  • Lafayette, LA
  • NPI 1730139858
  NPD (past)
• PT Pros, Inc.

  • Physical Therapist
  • Barbourville, KY
  • NPI 1366549370
  NPD (past)

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1033645494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705062652",
            "telephone_number": "337-981-9182",
            "fax_number": "337-988-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705062652",
            "telephone_number": "337-981-9182",
            "fax_number": "337-988-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Broussard
• Jamie Ryan Broussard II, MSN, APRN, PMHNP-BC
• Jessica Broussard, FNP-C
• Joan T. Broussard, A.C.N.P.
• Jodi K Broussard, R.D.
• Judd Tanner Broussard, CRNA
• Jude John Broussard, PHARM D
• Kelli Broussard
• Kenrard Broussard
• Kent Allan Broussard

• Physical Therapist in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.