Individual provider Active NPI

Tara Ann Brossard

  • Physical Therapy Assistant
  • Coral Springs, FL
National Provider Identifier
1649547787
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
22841 Issued in FL
Practice address
5099 NW 83Rd LN
Coral Springs, FL 33067-2803
Phone
(954) 618-8044
NPI assigned
Nov 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 22841 FL Primary

Addresses

Primary practice location

5099 NW 83Rd LN
Coral Springs, FL 33067-2803

Mailing address

5099 NW 83Rd LN
Coral Springs, FL 33067-2803
Phone (954) 618-8044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22841FLMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1649547787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5099 NW 83RD LN",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330672803",
            "telephone_number": "954-618-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5099 NW 83RD LN",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330672803",
            "telephone_number": "954-618-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSSARD",
        "first_name": "TARA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "22841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.