Individual provider Active NPI

Hilary Jean Broussard, M.A. SLP-CCC

  • Speech-Language Pathologist
  • Hermitage, TN
National Provider Identifier
1669946158
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6202 Issued in TN
Practice address
4347 Lebanon Pike
Hermitage, TN 37076-1243
Phone
(615) 871-8200
NPI assigned
Jan 17, 2019
Last updated
Jan 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6202 TN Primary

Addresses

Primary practice location

4347 Lebanon Pike
Hermitage, TN 37076-1243

Mailing address

210 30TH Ave N Apt 306
Nashville, TN 37203-1583
Phone (713) 315-7256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231221001445 TX Practitioner - Qualified Speech Language Pathologist 4789034414 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
112638TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation, LLC Speech-Language Pathologist CurrentSince Nov 22, 2023 Accepting new patients
Empowerme Rehabilitation, LLC Speech-Language Pathologist CurrentSince Nov 22, 2023 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

1501 W Campbell Rd
Garland, TX 75044
Phone (469) 609-9153

2300 Pool Rd
#G
Grapevine, TX 76051
Phone (833) 655-2840

4701 Ratcliffe Dr
Kyle, TX 78640
Phone (512) 920-4600

2760 W Walker St
League City, TX 77573
Phone (281) 967-7973

2022 Highway 46 W
New Braunfels, TX 78132
Phone (830) 743-9324

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1669946158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 30TH AVE N APT 306",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031583",
            "telephone_number": "713-315-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4347 LEBANON PIKE",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761243",
            "telephone_number": "615-871-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "HILARY",
        "middle_name": "JEAN",
        "credential": "M.A. SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "6202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.