Latresia Grace Broussard, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1307 Issued in LA

Practice address

331 Hospital Rd
New Roads, LA 70760-2622

Phone

(225) 618-8016

Fax

(225) 618-8028

NPI assigned

Nov 21, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Broussard Chiropractic Center, Inc

  • Chiropractor
  • New Roads, LA
  • NPI 1366590648
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679648109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 HOSPITAL RD",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707602622",
            "telephone_number": "225-618-8016",
            "fax_number": "225-618-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 HOSPITAL RD",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707602622",
            "telephone_number": "225-618-8016",
            "fax_number": "225-618-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "LATRESIA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509060",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Doucet Bordelon, M.D.
• Bridget Bordelon
• Catherine Theresa Bowman
• Brookshire Grocery Company
• Broussard Chiropractic Center, Inc
• Ken Brown, LPC
• Iryn Butler
• Shelley Faulk Carnahan
• Kathleen Carr
• Randall Cashio

• Chiropractor in New Roads, LA
• Providers in New Roads, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.