Kallyn Jones Broussard, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP08444 Issued in LA

Practice address

211 4TH St
Alexandria, LA 71301-8421

Phone

(337) 208-2361

NPI assigned

Jul 20, 2015

Last updated

Aug 25, 2023By 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

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rapides Regional Physician Group, Specialty Care, LLCGroup PAC ID 3375646466, 41 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.07 of 100Reported as group

Quality

65.81

Promoting interoperability

99

Improvement activities

40

Cost

68.17

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Rapides Regional Physician Group Specialty Care, LLC

  • Specialist
  • Alexandria, LA
  • NPI 1043309016
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1467836478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 4TH ST STE 5B",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018421",
            "telephone_number": "318-767-0605",
            "fax_number": "318-767-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 4TH ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018421",
            "telephone_number": "337-208-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "KALLYN JONES",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2023-08-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "AP08444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Patrick Brouillette
• Desiree Brouillette, CFM03594
• Melissa Ann Brouillette
• Blaine Mark Broussard, M.D.
• James Brian Broussard, P.A.
• Karissa Broussard
• Alayna Jordan Brown, OD
• Alisa Brown, MA
• Annie Marie Brown
• Celeste Brown

• Acute Care Nurse Practitioner in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Acute Care Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.