Carlos A Broussard, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

04660 Issued in LA

Practice address

600 N Lewis St
New Iberia, LA 70560

Phone

(337) 365-3168

Fax

(337) 369-3536

NPI assigned

Oct 5, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/ibermed-05842f36

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.

• Hospital Service District No. 1 of Iberia Parish

  dba Iberia Medical Center

  • General Acute Care Hospital
  • New Iberia, LA
  • NPI 1780690180
  Medicare reassignment NPD
• Youngs Professional Services LLC

  dba YPS Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Hospital Service District No 1 of Iberia Parish

  dba Iberia Medical Center

  • Rehabilitation Hospital Unit
  • New Iberia, LA
  • NPI 1992159925
  NPD
• Iberia Medical Center Physician Practice Network

  • Family Medicine Physician
  • New Iberia, LA
  • NPI 1518265297
  NPD
• Our Lady of Lourdes Regional Medical Center

  dba Lourdes Physician Billing Service

  • Neurology Physician
  • Lafayette, LA
  • NPI 1265593735
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1861588667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52533",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70505",
            "telephone_number": "337-365-3168",
            "fax_number": "337-369-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N LEWIS ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "70560",
            "telephone_number": "337-365-3168",
            "fax_number": "337-369-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "CARLOS",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "04660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1623393",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Brinton
• Brookshire Grocery Company (Super 1 Pharmacy)
• Broussard Hargrave & Shea LLC
• Kelly Louise Broussard-Jenkins
• Ajah Broussard
• Gerald Broussard, R.P.H.
• Harold Joseph Broussard, PA
• James R Broussard, LCSW
• Jeremy Broussard, D.C.
• Julie Broussard, RPH

• Certified Registered Nurse Anesthetist in New Iberia, LA
• Providers in New Iberia, 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 Mar 28, 2008; 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.