John Broussard, DO
NPI 1174839161 · Sports Medicine (Family Medicine) Physician · St Petersburg, FL
Enrolled with Medicare as Practitioner - Sports Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
John Broussard, DO is a Sports Medicine (Family Medicine) Physician provider in St Petersburg, FL (NPI 1174839161).
Provider details
- NPI number
- 1174839161
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- Yes
- License
- OS12241 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-08-27
- Last updated
- 2020-08-27
- Certified
- 2020-08-27
Frequently asked questions
- What is John Broussard's NPI number?
- John Broussard's National Provider Identifier (NPI) is 1174839161, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is John Broussard's specialty?
- John Broussard is listed in the NPPES registry with a primary specialty of Sports Medicine (Family Medicine) Physician (Allopathic & Osteopathic Physicians).
- Where is John Broussard located?
- John Broussard's practice location on file with NPPES is 111 2nd Ave Ne Ste 1401, St Petersburg, FL 33701-3480.
- What is John Broussard's phone number?
- The practice phone number listed in the NPPES registry for John Broussard is (727) 258-7224.
- Does John Broussard accept Medicare?
- John Broussard is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is John Broussard's NPI active?
- Yes — John Broussard's NPI (1174839161) is active in the NPPES registry as of the last update on 2020-08-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.