Nancy Rebecca Fisher Broussard, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2047-993AT Issued in LA

Practice address

1458 S College Rd
Lafayette, LA 70503-2912

Phone

(337) 237-2110

NPI assigned

Apr 24, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

David H Fisher Jr Inc the Vision ClinicGroup PAC ID 9830193457, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

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.

• David H Fisher Jr Inc the Vision Clinic

  • Optometrist
  • Lafayette, LA
  • NPI 1215048624
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1447006143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 MICAH EDWARD DR",
            "city": "MAURICE",
            "state": "LA",
            "postal_code": "705553395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 S COLLEGE RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032912",
            "telephone_number": "337-237-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "NANCY",
        "middle_name": "REBECCA FISHER",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "2047-993AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandi Broussard
• Mary Elizabeth Broussard, B.A., B.S.
• Melanie Cavalier Broussard
• Mitchell Neil Broussard, O.D.
• Morgan Broussard, SLP
• Natalie Broussard, N.P.
• Patricia Broussard
• Preston Broussard
• Qiana Broussard
• Rachel Lacy Broussard, LCSW

• Optometrist in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.