Crystal Marie Broussard, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AY1198 Issued in FL

Practice address

16251 N Cleveland Ave Ste 8
North Fort Myers, FL 33903-2176

Phone

(239) 997-8288

Fax

(239) 997-8084

NPI assigned

Nov 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Crystal Marie Goetz Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Cape Coral Ear Nose & Throat Center PL

  • Otolaryngology Physician
  • Cape Coral, FL
  • NPI 1942485487
  Medicare reassignment NPD
• Crystal Hearing Solutions, LLC

  • Audiologist
  • North Fort Myers, FL
  • NPI 1982238127
  NPD Authorized official
• Advanced Hearing Technology, Inc.

  • Audiologist
  • Bonita Springs, FL
  • NPI 1457377400
  NPD

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1770763559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16251 N CLEVELAND AVE STE 8",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339032176",
            "telephone_number": "239-997-8288",
            "fax_number": "239-997-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16251 N CLEVELAND AVE STE 8",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339032176",
            "telephone_number": "239-997-8288",
            "fax_number": "239-997-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2022-02-15",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "FL",
            "license": "AY1198",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "GOETZ",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "AU.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexandra G Bowen Cruzati, MASSAGE THERAPIST
• Karen Boyer, MPT
• Susana Bravo Carpente, RBT
• Micah Dray Brienen, OD
• Brooklyn Ripley
• Katherine Brown
• Sharon Lyn Buckley
• Niursy Maria Burgal Acosta
• Javier Burgos Zamora
• Editha Anne Butler, APRN

• Audiologist in North Fort Myers, FL
• Providers in North Fort Myers, FL by specialty
• Audiologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.