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NIKKI ILONA BROUSSARD CRNP
NPI 1043034580
Internal Medicine - Nephrology in Dothan, AL

Active since November 12, 2024PECOS EnrolledAccepts Medicare Assignment
207 HAVEN DR, DOTHAN, AL 36301(337) 793-3319 Get Directions Write a Review

NPPES record last updated: November 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nikki Ilona Broussard Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NIKKI ILONA BROUSSARD CRNP (NPI 1043034580) is an individual nephrology provider in Dothan, Alabama, licensed in Alabama (1-121127) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1043034580
Entity TypeIndividualFemale
Primary Taxonomy207RN0300X
Provider Legal NameNIKKI ILONA BROUSSARDCredential: CRNP
Location Address207 HAVEN DRDothan, AL 36301-2919
Mailing Address207 Haven DrDothan, AL 36301-2919 · (334) 793-3319
Phone(337) 793-3319
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateNovember 12, 2024
NPPES CertifiedNovember 12, 2024
✔ NPI 1043034580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in AL · 1-121127
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
207 HAVEN DR, Dothan, AL 36301
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nikki Ilona Broussard Crnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628599107
PECOS Enrollment IDI20250313000973
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DOTHAN HYPERTENSION NEPHROLOGY ASSOCIATES
Specialist
207 HAVEN DR
DOTHAN, AL 36301
Houston County (334) 793-3319
ELIZABETH ANN MCFARLAND CRNP
Nurse Practitioner (Family)
207 HAVEN DR
DOTHAN, AL 36301
Houston County (334) 793-3319
MRS. JENNIFER SMITH KIRK CRNP
Nurse Practitioner (Family)
207 HAVEN DR
DOTHAN, AL 36301
Houston County (334) 793-3319
MRS. STEFANIE L. KINCEY CRNP
Nurse Practitioner
207 HAVEN DR
DOTHAN, AL 36301
Houston County (334) 793-3319
DR. VENKAT R NIMMAGADDA M.D.
Internal Medicine (Nephrology)
207 HAVEN DR
DOTHAN, AL 36301
Houston County (334) 793-3319
RAVINDRANATH V. KANTAMNENI M.D.
Internal Medicine (Nephrology)
207 HAVEN DR
DOTHAN, AL 36301
Houston County (334) 793-3319
DR. NOWOGHOMWENMA CHARLES IBIE MD
Internal Medicine (Nephrology)
207 HAVEN DR
DOTHAN, AL 36301
Houston County (334) 793-3319
LINDA HETRICK LPN
Licensed Practical Nurse
207 HAVEN DR
DOTHAN, AL 36301
Houston County (334) 793-1964

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nikki Broussard's NPI number?

The NPI number for Nikki Broussard is 1043034580. It was assigned to this individual provider in the NPPES registry on November 12, 2024.

Where is Nikki Broussard located?

Nikki Broussard practices at 207 Haven Dr, Dothan, AL 36301. The listed phone number is (337) 793-3319.

What is Nikki Broussard's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Nikki Broussard enrolled in Medicare?

Yes. Nikki Broussard is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nikki Broussard accept?

Health plans from Blue Cross and Blue Shield of Alabama and UnitedHealthcare list Nikki Broussard as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nikki Broussard was last updated on November 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.