Active NPI
Shea Denise Broussard, M.A.
- Acupuncturist
- Durham, NC
National Provider Identifier
1891543963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 630
- Practice address
- 2011 Chapel Hill Rd
Durham, NC 27707-1109 - Phone
- (512) 294-3435
- NPI assigned
- May 13, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 630 | NC | Primary |
Addresses
Primary practice location
2011 Chapel Hill Rd
Durham, NC 27707-1109
Mailing address
8610 Bromley Rd
Hillsborough, NC 27278-8017
Phone (512) 294-3435
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 630 | NC | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1891543963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8610 BROMLEY RD",
"city": "HILLSBOROUGH",
"state": "NC",
"postal_code": "272788017",
"telephone_number": "512-294-3435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 CHAPEL HILL RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277071109",
"telephone_number": "512-294-3435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSARD",
"first_name": "SHEA",
"middle_name": "DENISE",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-13",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NC",
"license": "630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.