DR. TAJAKI LEWIS BROUSSARD (NPI# 1831728203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831728203 |
| Entity Type | Individual |
| Full Name | DR. TAJAKI LEWIS BROUSSARD |
| Practice Address |
3700 Macon Rd Columbus GA 31907-2248 |
| Mailing Address |
5 Woodchase Ct Phenix City AL 36870-2503 |
| Practice Telephone | 7065686878 |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PHI-018176 | GA | Pharmacy Service Providers |
| Street Address |
3700 MACON RD |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31907-2248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417964495 | Walgreen Co | Pharmacy | 3700 Macon Rd, Columbus, GA 31907-2248 | 2006-08-02 |
| 1821366311 | Gina Catherine Nussbaumer | Pharmacist | 3700 Macon Rd, Columbus, GA 31907-2248 | 2011-12-12 |
| 1952686487 | Gretchen Steffey Gray | Pharmacist | 3700 Macon Rd, Columbus, GA 31907-2248 | 2011-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702051 | At Ease Private Home Care, LLC | Home Health | 3906 Pond View Court, Columbus, GA 31907 | 2020-05-20 |
| 1285268219 | Mh 102, PC | Nurse Practitioner | 1 Aflac Parkway, Columbus, GA 31907 | 2020-02-28 |
| 1427602978 | Alicia Keeshan Taylor | Massage Therapist | 5401 Gunboat Dr Unit 31, Columbus, GA 31907 | 2019-08-01 |
| 1285101071 | Valerie Rena Bickham | Chore Provider | 1259 Bismarck Drive, Columbus, GA 31907 | 2018-10-30 |
| 1629555172 | West Georgia Regenerative Medicine LLC | Physical Therapist | 3624 Edgewood Rd Ste B, Columbus, GA 31907 | 2018-07-26 |
| 1659866747 | Transitional Independence, LLC | In Home Supportive Care | 5633 Lexington Dr, Columbus, GA 31907 | 2018-06-29 |
| 1598285892 | Aa Personal Care, LLC | Nursing Care | 547 Moye Rd, Columbus, GA 31907 | 2017-06-27 |
| 1366981573 | Sabrina Renae Crosby Lopes | Counselor | 1120 21st Unit -a, Columbus, GA 31907 | 2017-02-21 |
| 1326445073 | Angela James | Nurse Practitioner | 6400 Flatrock Road, Columbus, GA 31907 | 2014-11-24 |
| 1841617255 | Sabrina Ann Patterson | Community Health Worker | 2726 Courtland, Columbus, GA 31907 | 2014-03-24 |
| Find all providers in zip 31907 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391730 | Dominic Clouse | Pharmacist | Jameson Crane Sports Medicine Institute Pharmacy, 2835 Fred Taylor Drive, Columbus, OH 43202 | 2020-06-24 |
| 1225663602 | Farzaneh Gyurcsik | Pharmacist | 2826 Doncaster Rd, Columbus, OH 43221-3034 | 2020-03-06 |
| 1396386421 | Erin Petersen | Pharmacist | 3535 Olentangy River Rd Ste Y1322, Columbus, OH 43214-3908 | 2019-09-30 |
| 1659927945 | Nicholas D Keller | Pharmacist | 181 Taylor Ave Ste Tg135, Columbus, OH 43203-1779 | 2019-08-13 |
| 1942854005 | Eric Obeng | Pharmacist | 2575 S Hamilton Rd, Columbus, OH 43232-4964 | 2019-07-27 |
| 1518421015 | Andrew Carlisle Milner | Pharmacist | 5445 N. High St, Columbus, OH 43214-1129 | 2019-01-29 |
| 1598247371 | Alyssa Marie Gaietto | Pharmacist | 460 W 10th Ave Rm C150d, Columbus, OH 43210-1240 | 2018-08-29 |
| 1851879209 | Lauren R. Vergara | Pharmacist | 410 W 10th Avenue, 368 Doan Hall, Columbus, OH 43215-2447 | 2018-07-29 |
| 1992282081 | Ali Mohamed | Pharmacist | 3949 Hoffman Valley Dr, Columbus, OH 43219-8111 | 2018-07-23 |
| 1417433467 | Jon Theodore Mcclymont | Pharmacist | 1599 Alum Creek Dr, Columbus, OH 43209-2596 | 2018-07-12 |
| Find all providers in COLUMBUS | ||||
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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.