Big Blue Star LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

BIG BLUE STAR LLC

Doing business as

WeightWise

Practice address

1800 Renaissance Blvd Ste 200
Edmond, OK 73013-3023

Phone

(404) 359-2473

NPI assigned

Nov 12, 2009

Last updated

Dec 17, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Toby Daniel Broussard, MD

Title

Co Owner

Phone

(405) 974-8412

Specialties & licenses 4

Addresses

Other names 1

• WeightWise Doing business as

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1396072344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 RENAISSANCE BLVD STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133023",
            "telephone_number": "404-359-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 RENAISSANCE BLVD STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133023",
            "telephone_number": "404-359-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG BLUE STAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "TOBY",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "405-974-8412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WeightWise",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hanisha P Bhakta
• Pooja Bhakta, PA-C
• Ishan Raj Bhanot
• Nilaksha Bhatt, M.D.
• Terri Lynn Bieri, M.A.
• Big Love Counseling and Wellness
• Kelsey Lyn Bigheart
• Troyya Biglow
• Bill Spence Ms, LPC Professional Corp.
• Abigail Billen, CCC-SLP

• Registered Dietitian in Edmond, OK
• Providers in Edmond, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.