DR. AUSTIN JOSEPH BROUSSARD (NPI# 1821625666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821625666 |
| Entity Type | Individual |
| Full Name | DR. AUSTIN JOSEPH BROUSSARD |
| Credential | MD |
| Practice Address |
124 S Humes St Memphis TN 38111-1918 |
| Mailing Address |
4144 Cleveland Ave New Orleans LA 70119-5902 |
| Practice Telephone | 8654143453 |
| Mailing Telephone | 5045684680 |
| Mailing Fax Number | 5045684466 |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
124 S HUMES ST |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38111-1918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982168035 | Meghan Weakley Pace | Occupational Therapist | 177 North Highlanld Ave, Memphis, TN 38111 | 2019-01-23 |
| 1386130466 | Christopher Cory Wilbanks | Nurse Practitioner | 3445 Poplar Ave Ste 18, Memphis, TN 38111 | 2018-07-02 |
| 1124523287 | Hands of Health and Rehab | Clinic/Center | 80 N. Tillman St. Ste. 104, Memphis, TN 38111 | 2018-03-29 |
| 1659889889 | Jarod Lenahan | Specialist/Technologist | 1115 East Getwell Loop St, Memphis, TN 38111 | 2018-01-22 |
| 1831645100 | Bobby Winbush | Residential Treatment Facility, Emotionally Disturbed Children | 1167 Parkland Rd, Memphis, TN 38111 | 2016-08-28 |
| 1356797427 | Shilo Satran | Counselor | 208 Waynoka Lane, Memphis, TN 38111 | 2016-05-09 |
| 1346580552 | Bianca Branch | Psychologist | 4166 W Bufford Ellington Dr, Memphis, TN 38111 | 2013-02-25 |
| 1043563935 | Midsouth Vision Center | Optometrist | 3314 Poplar Ave Ste#1, Memphis, TN 38111 | 2012-10-17 |
| 1235407750 | Demetria Nicole Rogers | Pharmacist | 3515 Park Avenue, Memphis, TN 38111 | 2011-12-12 |
| 1326335647 | Jason Thomas Sasser | Nurse Practitioner | 3444 Plaza Ave., The Little Clinic, Memphis, TN 38111 | 2011-07-07 |
| Find all providers in zip 38111 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252013 | Rhaina Johnson | Student in an Organized Health Care Education/Training Program | 2639 Central Ave Apt V1, Memphis, TN 38104-5954 | 2020-07-20 |
| 1821606021 | Stephanie Bell | Student in an Organized Health Care Education/Training Program | 5091 Windcrest Rd, Memphis, TN 38116-8526 | 2020-07-14 |
| 1245857077 | Melissa Rodriguez Analco | Student in an Organized Health Care Education/Training Program | 4343 Emily Ave, Memphis, TN 38122-4822 | 2020-06-27 |
| 1316564321 | Piper Black | Student in an Organized Health Care Education/Training Program | Uthsc College of Nursing 920 Madison Avenue, Memphis, TN 38163-0001 | 2020-06-26 |
| 1225654726 | Karen Y Wilson | Student in an Organized Health Care Education/Training Program | The University of Tennessee Health Science Center, 920 Madison Ave., Memphis, TN 38163-4774 | 2020-06-19 |
| 1881216356 | Asif Jamal | Student in an Organized Health Care Education/Training Program | 865 Jefferson Ave Ste F150, Memphis, TN 38103-2807 | 2020-05-07 |
| 1992325468 | Zebin Mohammad Al Zebin | Student in an Organized Health Care Education/Training Program | 288 Night Sail Dr S Apt 107, Memphis, TN 38103-1724 | 2020-04-24 |
| 1922627637 | Krystal Lugo | Student in an Organized Health Care Education/Training Program | 3940 Summer Breeze Cv, Memphis, TN 38125-2840 | 2020-04-13 |
| 1336768092 | Preeti Singh | Student in an Organized Health Care Education/Training Program | 853 Jefferson Chandler F150, Memphis, TN 38163-0001 | 2020-04-13 |
| 1588283410 | Elizabeth Chandler Lee | Student in an Organized Health Care Education/Training Program | 545 Club Walk, Memphis, TN 38111-3200 | 2020-04-10 |
| Find all providers in MEMPHIS | ||||
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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.