Shanika Broussard

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

6163 E Lamar St
Bay Saint Louis, MS 39520-8267

Phone

(504) 908-5893

NPI assigned

Nov 11, 2020

Last updated

Nov 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• By Karrying Empathy Homecare LLC

  • Adult Companion
  • Gulfport, MS
  • NPI 1083216337
  NPD Authorized official
• Tsaleach Lab Solutions LLC

  • Clinical Medical Laboratory
  • Bay Saint Louis, MS
  • NPI 1689325490
  NPD Authorized official

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1265034516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 COWAN RD.",
            "address_2": "SUITE B #2014",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39507",
            "telephone_number": "228-254-3037",
            "fax_number": "228-335-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6163 E LAMAR ST",
            "city": "BAY SAINT LOUIS",
            "state": "MS",
            "postal_code": "395208267",
            "telephone_number": "504-908-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "SHANIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.bkempathyhomecare.com/",
            "affiliation": "N",
            "endpointDescription": "Homecare Agency",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6163 E LaMar St",
            "city": "Bay Saint Louis",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395208267",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.bkempathyhomecare.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "6163 E LaMar St",
            "city": "Bay Saint Louis",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395208267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adult Companion in Bay Saint Louis, MS
• Providers in Bay Saint Louis, MS by specialty
• Adult Companion in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.