Benjamin Patrick Brouillette

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

0994 Issued in LA

Practice address

3600 Jackson St
Alexandria, LA 71303-3040

Phone

(318) 625-7050

NPI assigned

Aug 3, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1235866906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HIDDEN PATH DR",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713602202",
            "telephone_number": "318-794-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 JACKSON ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033040",
            "telephone_number": "318-625-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "BENJAMIN",
        "middle_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": "0994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LAST FOUR",
            "identifier": "0994",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.3h-la.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "3600 Jackson St Ste 119",
            "city": "Alexandria",
            "state": "LA",
            "country_code": "US",
            "postal_code": "713033096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yolanda Ann Brooks
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• Korey Elise Brossett
• Sabrina Brossett
• Desiree Brouillette, CFM03594
• Melissa Ann Brouillette
• Blaine Mark Broussard, M.D.
• James Brian Broussard, P.A.
• Kallyn Jones Broussard, NP

• Case Manager/Care Coordinator in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.