MR. ANDREA BROUSSARD (NPI# 1538605027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1538605027 |
Entity Type | Individual |
Full Name | MR. ANDREA BROUSSARD |
Practice Address |
406 Pass Rd Gulfport MS 39507 |
Mailing Address |
406 Pass Rd Gulfport MS 39507-2901 |
Practice Telephone | 2866998402 |
Mailing Telephone | 2866999840 |
Enumeration Date | 2017-01-09 |
Last Update Date | 2019-02-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 146D00000X | Personal Emergency Response Attendant | Emergency Medical Service Providers | ||
N | 172A00000X | Driver | Other Service Providers | ||
N | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers | ||
Y | 374U00000X | Home Health Aide | MS | Nursing Service Related Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 104736701 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
406 Pass Rd, Gulfport, MS 39507 | 2866998402 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659811784 | Andrea Broussard | Occupational Therapist | 3840 Hulen St, Fort Worth, TX 76107-7277 | 2017-03-08 |
Street Address |
406 PASS RD |
City | GULFPORT |
State | MS |
Zip Code | 39507 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609389105 | Karen R Burns | Speech-Language Pathologist | 3506 Washington Avenue, Ste E, Gulfport, MS 39507 | 2017-11-07 |
1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
1740599380 | Advanced Hearing Systems, Inc. | Hearing Instrument Specialist | 401 Security Square, Gulfport, MS 39507 | 2010-09-30 |
1497068118 | Stacey Ritter Carter | Dentist | 1635 East Pass Road, Gulfport, MS 39507 | 2010-07-22 |
1477789964 | Letonoff Orthopaedics & Sports | Orthopaedic Surgery | 452 Court House Road, Suite G, Gulfport, MS 39507 | 2009-06-10 |
1730385139 | Bernard Frederick Podlin | Dentist | 400 Pass Road, Gulfport, MS 39507 | 2007-06-22 |
1043422553 | Mark D Stringer | Dentist | 520-a Courthouse Road, Gulfport, MS 39507 | 2007-05-04 |
1154543528 | Pass Road Elementary | Registered Nurse | 37 Pass Road, Gulfport, MS 39507 | 2007-05-03 |
1417073768 | John Hough Hopkins | Dentist | 3303 A Ave, Gulfport, MS 39507 | 2007-03-21 |
1619003191 | Arthur Tripp | Chiropractor | 422 Security Square, Dr Arthur Tripp Traditional Chiropractic, Gulfport, MS 39507 | 2007-02-26 |
Find all providers in zip 39507 |
Taxonomy Code | 374U00000X |
Grouping | Nursing Service Related Providers |
Classification | Home Health Aide |
A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. |
Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023635356 | Royalty Home Care Health Care Business | Home Health Aide | 1073 Acadian Dr Ste B, Gulfport, MS 39507-3538 | 2020-07-02 |
1568004398 | Shavoka L Jackson | Home Health Aide | 20375 Secretariat, Gulfport, MS 39503-4596 | 2019-10-14 |
1366904518 | Amesha Barnes | Home Health Aide | 1232 Camp Ave, Gulfport, MS 39501-2440 | 2019-04-04 |
1194231399 | Dortha Mae Rideout | Home Health Aide | 2649 Palmer Dr, Gulfport, MS 39507-2846 | 2017-12-26 |
1972884211 | Betty Fields | Home Health Aide | 1529 43rd Ave Apt 103, Gulfport, MS 39501-3701 | 2011-08-31 |
1639310899 | Valford White | Home Health Aide | 4930 10th Ave S, Gulfport, FL 33707-2625 | 2009-03-18 |
1255635074 | Helping Hands LLC (respite Care) | Home Health Aide | 12266 Ashley Dr, Gulfport, MS 39503-2759 | 2011-01-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184230229 | Tammy Louise Lavigne | Home Health Aide | 166 Woodland Way, Jackson, MS 39209-3566 | 2020-09-22 |
1841804044 | David Johnson | Home Health Aide | 4436 Davis Grove Blvd, Olive Branch, MS 38654-5631 | 2020-09-04 |
1013521707 | Ashley M Hyche | Home Health Aide | 115 Thornhill Dr Ste A, Hattiesburg, MS 39402-1559 | 2020-09-01 |
1881203420 | Robyn Winn | Home Health Aide | 119 E Semmes St, Canton, MS 39046-4527 | 2020-07-29 |
1376152512 | Jackson Ms Homecare | Home Health Aide | 2625 Ridgewood Rd Ste 104, Jackson, MS 39216-4900 | 2020-07-23 |
1275141186 | Precious Holmes | Home Health Aide | 1321 Sunset Dr Ste A, Grenada, MS 38901-4005 | 2020-07-16 |
1770100109 | Shanterika Tate | Home Health Aide | 5407 Martin Luther King Blvd, Moss Point, MS 39563-4543 | 2020-07-01 |
1831714260 | Jakayla Palmer | Home Health Aide | 101 Sunset Dr, Clinton, MS 39056-5211 | 2020-06-11 |
1679196265 | Samantha Catchings | Home Health Aide | 901 N Bennett St, Crystal Springs, MS 39059-2501 | 2020-05-18 |
1447871579 | Stewart Health Care Training Academy | Home Health Aide | 522 West Park Avenue Suite S, Greenwood, MS 38930 | 2020-04-29 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.