Active NPI
Bartel Henri Broussard, PT, DPT
- Physical Therapist
- Marysville, WA
National Provider Identifier
1730770983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT61075614
- Practice address
- 9802 48TH Dr NE
Marysville, WA 98270 - Phone
- (425) 614-7372
- NPI assigned
- Jan 31, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT61075614 | WA | Primary |
Addresses
Primary practice location
9802 48TH Dr NE
Marysville, WA 98270
Mailing address
3612 Lombard Ave
Everett, WA 98201
Phone (425) 614-7372
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615852800000",
"number": "1730770983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3612 LOMBARD AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "98201",
"telephone_number": "425-614-7372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9802 48TH DR NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "98270",
"telephone_number": "425-614-7372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSARD",
"first_name": "BARTEL",
"middle_name": "HENRI",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-31",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT61075614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.