Kelly M Broussard, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P18088 Issued in NC

Practice address

1168 E Cutlar Xing
Leland, NC 28451-6484

Phone

(919) 332-3800

Fax

(919) 251-0421

NPI assigned

Dec 9, 2019

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

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Drexel University College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.07 of 100Reported as group

Quality

85.94

Promoting interoperability

100

Improvement activities

40

Cost

77.63

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.broussard.1@847.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 and National Provider Directory roles.

• Emergeortho PA

  • Orthopaedic Surgery Physician
  • Durham, NC
  • NPI 1376592964

  NC, Physical Therapist

  Medicare reassignment NPD
• Emergeortho PA

  • Durable Medical Equipment & Medical Supplies
  • Eden, NC
  • NPI 1841170222
  NPD
• Ati Holdings, LLC

  • Physical Therapy Clinic/Center
  • Rising Sun, MD
  • NPI 1396781050

  Physical Therapist

  NPD
• Ati Holdings, LLC

  • Durable Medical Equipment & Medical Supplies
  • King of Prussia, PA
  • NPI 1750194460

  Physical Therapist

  NPD

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1801433958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255",
            "fax_number": "919-220-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1168 E CUTLAR XING",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516484",
            "telephone_number": "919-332-3800",
            "fax_number": "919-251-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "KELLY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27089",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P18088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Bradford, DMD
• Matthew Jordan Bradshaw, DC
• Kaitlyn Marie Brannin
• Thomas J Braza, MD
• Meghan Luisa Dalziel Brooks, O.D.
• Brunswick Surgery Center LLC
• Brunswick Urgent Care
• Eric Christopher Bryant, OD
• James M Buchanan Jr., DDS
• Kelli Lee Buell

• All providers in Leland, NC
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.