Kendra Broussard, WHNP, AGPCNP, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2292034 Issued in MA

Practice address

101 Court St Ste 8
Plymouth, MA 02360-8718

Phone

(508) 732-7327

NPI assigned

Sep 24, 2015

Last updated

Oct 1, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kendra.demakis.1@14.direct.athenahealth.com

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.

• Beth Israel Deaconess Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1548202641
  Medicare reassignment NPD
• Health Imperatives Inc.

  dba Brockton Family Planning

  • Non-Surgical Family Planning Clinic/Center
  • Brockton, MA
  • NPI 1760526420
  Medicare reassignment NPD
• Beth Israel Deaconess Medical Center, Inc.

  • Ambulance
  • Boston, MA
  • NPI 1518600501
  NPD
• Health Imperatives Inc.

  dba Plymouth Family Planning

  • Non-Surgical Family Planning Clinic/Center
  • Plymouth, MA
  • NPI 1861536906
  NPD
• Deborah S. Wooten, M.D., LLC

  • Gynecology Physician
  • Norwell, MA
  • NPI 1255514923
  NPD (past)
• KMG Medical Group Mo, P.C.

  • Family Medicine Physician
  • Lexington, KY
  • NPI 1730844085
  NPD (past)

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1730558313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SAXTON ST UNIT 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021251439",
            "telephone_number": "781-264-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COURT ST STE 8",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023608718",
            "telephone_number": "508-732-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "KENDRA",
        "credential": "WHNP, AGPCNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "2292034",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "2292034",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "2292034",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "2292034",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridge Behavior Services, LLC
• Bright Solutions
• Kathleen E Brodt, NURSE PRACTITIONER
• Ryan Patrick Brogan, NP
• Joel Jacole Brooks
• Casey Brown, PA-C
• Ellen H Brown, MS, RN, APRN,BC,
• Sancheska Brown
• Sandra Brown
• Denise L Brownell, PT

• Nurse Practitioner in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.