Kimberly Epperly Broussard, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1022530

Practice address

12269 La Hwy 699
Maurice, LA 70555-3604

Phone

(337) 658-9188

Fax

(337) 658-9188

NPI assigned

Feb 28, 2025

Last updated

Feb 28, 2025By 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

Other names 1

• Kimberly Raeann Epperly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1184421877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12269 LA HWY 699",
            "city": "MAURICE",
            "state": "LA",
            "postal_code": "705553604",
            "telephone_number": "337-658-9188",
            "fax_number": "337-658-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12269 LA HWY 699",
            "city": "MAURICE",
            "state": "LA",
            "postal_code": "705553604",
            "telephone_number": "337-658-9188",
            "fax_number": "337-658-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "KIMBERLY",
        "middle_name": "EPPERLY",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1022530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "EPPERLY",
            "middle_name": "RAEANN",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cher Yan Aymond, MD
• Emily Barousse Alleman, FNP
• Gabrielle Mire Black, PA
• Amanda Percle Broussard, LCSW
• Kali A Broussard, MD
• Latasha Broussard
• Nicholas Paul Broussard, CRNA
• Jordan Clavier
• Alaina Dartez, LMSW
• Heather Naomi Davidson, D.C.

• Registered Dietitian in Maurice, LA
• Providers in Maurice, LA by specialty
• Registered Dietitian in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.