Active NPI
Jill Broussard, PT
- Physical Therapist
- Baton Rouge, LA
National Provider Identifier
1184948390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 01473R
- Practice address
- 5851 Shakespeare Dr
Baton Rouge, LA 70817-2914 - Phone
- (225) 751-2303
- NPI assigned
- Mar 16, 2010
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 01473R | LA | Primary |
Addresses
Primary practice location
5851 Shakespeare Dr
Baton Rouge, LA 70817-2914
Mailing address
5851 Shakespeare Dr
Baton Rouge, LA 70817-2914
Phone (225) 751-2303
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01473R | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268697600000",
"number": "1184948390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5851 SHAKESPEARE DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708172914",
"telephone_number": "225-751-2303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5851 SHAKESPEARE DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708172914",
"telephone_number": "225-751-2303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSARD",
"first_name": "JILL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-16",
"last_updated": "2010-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "01473R",
"primary": true
}
],
"identifiers": [],
"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 Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.