Courtney J Broussard, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN108581 Issued in LA

Practice address

4200 Houma Blvd
Metairie, LA 70006-2970

Phone

(504) 779-5515

NPI assigned

Nov 17, 2010

Last updated

Sep 30, 2020By the provider in NPPES

Sex

Male

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 IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Samaritan Regional Health CenterGroup PAC ID 1658272059, 155 clinicians

Anesthesia Associates of Southern Illinois Surgery Center LLCGroup PAC ID 0648555433, 22 clinicians

St Marys Hospital Centralia IllinoisGroup PAC ID 6709788920, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
• SSM Health St Mary's Hospital -Centralia Hospital, Centralia, IL, CCN 140034

Merit-based Incentive Payment System (MIPS)

Final score

98.77 of 100Reported as group

Quality

85.58

Promoting interoperability

100

Improvement activities

40

Cost

76.99

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

92.55

Promoting interoperability

100

Improvement activities

40

Cost

79.49

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Anesthesia Associates of Southern Illinois Surgery Center LLC

  • Anesthesiology Physician
  • Mount Vernon, IL
  • NPI 1043757487

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1487758801
  Medicare reassignment Care Compare group NPD
• St. Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1770687196
  Medicare reassignment Care Compare group NPD
• St. Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • Anesthesiology Physician
  • Centralia, IL
  • NPI 1477097871
  NPD
• St. Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Centralia, IL
  • NPI 1710105192
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation
• St Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1720389141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "800-242-1131",
            "fax_number": "517-787-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-779-5515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Ricker Rd",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "IL",
            "postal_code": "628814263",
            "country_code": "US",
            "telephone_number": "618-548-3194",
            "fax_number": "618-740-0122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "COURTNEY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-17",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN108581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Broomfield
• Michael Nelson Brothers, M.D.
• Rita Broughton, LPN
• Lynn Brouillette
• Colleen Elaine Broussard, CCC-SLP
• Crystal Broussard, PHD, LCSW
• Deborah Ann Broussard, O.D.
• Erika May Broussard, FNP
• Jamie W Broussard, MD
• Laverne Broussard

• Certified Registered Nurse Anesthetist in Metairie, LA
• Providers in Metairie, LA by specialty
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.