Individual provider Active NPI

Camille Angela Broussard, M.D., M.P.H.

  • Pediatric Adolescent Medicine Physician
  • Annapolis, MD
National Provider Identifier
1134461569
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
D0081897 Issued in MD
Practice address
200 Forbes St Ste 200
Annapolis, MD 21401-1527
Phone
(410) 263-6363
Fax
(410) 263-7551
NPI assigned
Mar 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X D0081897 MD Primary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X D0081897 MD

Addresses

Primary practice location

200 Forbes St Ste 200
Annapolis, MD 21401-1527

Mailing address

200 Forbes St Ste 200
Annapolis, MD 21401-1599
Phone (410) 263-6363

Other practice location 1

The Johns Hopkins Hospital
1800 Orleans Street
Baltimore, MD 21287-0001
Phone (410) 955-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0081897MDMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trusted Doctors LLC Past Accepting new patients
Trusted Doctors LLC PastSince Feb 25, 2024 Accepting new patients
Trusted Doctors LLC PastSince Feb 25, 2024 Accepting new patients
Trusted Doctors LLC PastSince Feb 25, 2024 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1134461569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FORBES ST STE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011599",
            "telephone_number": "410-263-6363",
            "fax_number": "410-263-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FORBES ST STE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011527",
            "telephone_number": "410-263-6363",
            "fax_number": "410-263-7551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "The Johns Hopkins Hospital",
            "address_2": "1800 Orleans Street",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870001",
            "country_code": "US",
            "telephone_number": "410-955-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "CAMILLE",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-24",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "D0081897",
            "primary": true
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "MD",
            "license": "D0081897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.