Active NPI
Joan Broussard, PHARM.D.
- Pharmacist
- Baton Rouge, LA
National Provider Identifier
1043763022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.021634
- Practice address
- 17000 Medical Center Dr
Baton Rouge, LA 70816-3246 - Phone
- (225) 752-2470
- NPI assigned
- Jul 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.021634 | LA | Primary |
Addresses
Primary practice location
17000 Medical Center Dr
Baton Rouge, LA 70816-3246
Mailing address
17000 Medical Center Dr
Baton Rouge, LA 70816-3246
Phone (225) 752-2470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PST.021634 | Other | LA | LOUISIANA BOARD OF PHARMACY LICENSED PHARMACIST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.021634 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473638400000",
"number": "1043763022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17000 MEDICAL CENTER DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708163246",
"telephone_number": "225-752-2470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17000 MEDICAL CENTER DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708163246",
"telephone_number": "225-752-2470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSARD",
"first_name": "JOAN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-26",
"last_updated": "2016-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.021634",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOUISIANA BOARD OF PHARMACY LICENSED PHARMACIST",
"identifier": "PST.021634",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.