Marla Broussard, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0024169450 Issued in VA

Practice address

816 Independence Blvd
Ste. 2a
Virginia Beach, VA 23455-6010

Phone

(757) 363-6230

Fax

(757) 363-6204

NPI assigned

Jan 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HFDFBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Naples Anesthesia, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Naples, FL
  • NPI 1316181126
  Medicare reassignment NPD
• Iberia Gastroenterology Associates, Inc. a Professional Medical Corpor

  • Gastroenterology Physician
  • New Iberia, LA
  • NPI 1962526509
  NPD
• SMG Anesthesia Specialists LLC

  • Anesthesiology Physician
  • Virginia Beach, VA
  • NPI 1518205004
  NPD (past)
• Kanumuri Medical Group PA

  • Anesthesiology Physician
  • Lake Wales, FL
  • NPI 1093761504
  NPD (past)
• Lafayette Health Ventures, Inc

  • Internal Medicine Physician
  • Lafayette, LA
  • NPI 1467687186
  NPD (past)
• North Houston Anesthesiologists, PA

  • Anesthesiology Physician
  • Kingwood, TX
  • NPI 1760495725

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1659601607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 INDEPENDENCE BLVD",
            "address_2": "STE. 2A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556010",
            "telephone_number": "757-363-6230",
            "fax_number": "757-363-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 INDEPENDENCE BLVD",
            "address_2": "STE. 2A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556010",
            "telephone_number": "757-363-6230",
            "fax_number": "757-363-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "MARLA",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "079980",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024169450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA LICENSE NUMBER",
            "identifier": "079980",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX NURSING LICENSE",
            "identifier": "768704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Brothers
• Tamara J Brothers, OD
• Steven Lee Broudy
• Allison Oliver Broughton, MA
• Virginia Lynn Broun, LPTA
• William D. Browder, MD
• Brown Stone Family Services, LLC
• Victoria Brown-O'Brien
• Alexis Brown
• Alyssa Mae Brown, FNP

• Certified Registered Nurse Anesthetist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Certified Registered Nurse Anesthetist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.