Christine Beall Broussard, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3161 Issued in AR

Practice address

8109 Interstate 30
Little Rock, AR 72209-4840

Phone

(501) 562-5400

Fax

(501) 562-8577

NPI assigned

Apr 18, 2011

Last updated

Apr 18, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1174813679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12611 TIMBER HILL DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113392",
            "telephone_number": "501-562-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8109 INTERSTATE 30",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722094840",
            "telephone_number": "501-562-5400",
            "fax_number": "501-562-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "CHRISTINE",
        "middle_name": "BEALL",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "3161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.