Victoria Burger Broussard, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

18319 Issued in NC

Practice address

2579 Eric LN Ste K
Burlington, NC 27215-5416

Phone

(336) 270-5304

NPI assigned

Oct 29, 2018

Last updated

Oct 29, 2018By 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 NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Legacy Healthcare Services, Inc.

  • Physical Therapist
  • Durham, NC
  • NPI 1104823400

  Pediatrics

  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1568939585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2579 ERIC LN STE K",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155416",
            "telephone_number": "336-270-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 ERIC LN STE K",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155416",
            "telephone_number": "336-270-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "VICTORIA",
        "middle_name": "BURGER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "18319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bromarhermbritt Center LLC
• Kailey Brooks
• Laquida Brooks, RN
• Sinterria Renea Brooks, PMHNP-BC
• Tammy Hall Brooks, FNP
• Adam Michael Brown, LCAS-A
• Andalicia T Brown, LCMHCA
• Fallon Eileen Brown, NP
• Imani Brown
• Joseph R. Brown, PHARMD

• Pediatric Physical Therapist in Burlington, NC
• Providers in Burlington, NC by specialty
• Pediatric Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.