1. Home
  2. Directory
  3. Louisiana
  4. Shreveport
  5. Physician Assistant
  6. NPI Profile

JO DEE GOODEAUX BROUSSARD PA
NPI 1578890190
Physician Assistant in Shreveport, LA

Active since November 04, 2009
1455 E BERT KOUNS LOOP, SUITE #210, SHREVEPORT, LA 71105(318) 798-4623(318) 798-4646 Get Directions Write a Review

NPPES record last updated: October 6, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jo Dee Goodeaux Broussard Pa NPPES

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

JO DEE GOODEAUX BROUSSARD PA (NPI 1578890190) is an individual physician assistant in Shreveport, Louisiana, licensed in Louisiana (PA200320) and active in the NPI registry since November 2009. She maintains a secondary practice location in Shreveport.

NPPES Registry Identity

NPI1578890190
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJO DEE GOODEAUX BROUSSARDCredential: PA
Location Address1455 E BERT KOUNS LOOP, SUITE #210Shreveport, LA 71105-5634
Mailing Address108 Rue Louis XivLafayette, LA 70508-5739 · (337) 235-8007 · Fax (855) 270-5479
Phone(318) 798-4623
Fax(318) 798-4646
Sole ProprietorNo
Enumeration DateNovember 4, 2009
Last NPPES UpdateOctober 6, 2017
✔ NPI 1578890190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in LA · PA200320
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1455 E BERT KOUNS LOOP, Shreveport, LA 71105
Open in Google Maps ↗

Secondary Practice Location 1

Location 11455 E Bert Kouns Loop, Suite #210Shreveport, LA 71105-5634 · Phone (318) 798-4623 · Fax (318) 798-4646

Other Identifiers 2

Medicaid1808181LA
Medicare PIN269457YJS0LA

Other Providers at the Same Location NPPES 20

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

PAUL A RUSHING MD
Internal Medicine
1455 E BERT KOUNS LOOP
SHREVEPORT, LA 71105
Caddo Parish (318) 798-4488
DR. ROAN L FLENNIKEN MD
Internal Medicine
1455 E BERT KOUNS LOOP
SHREVEPORT, LA 71105
Caddo Parish (318) 798-4577
KENNETH BETZING PA-C
Physician Assistant
1455 E BERT KOUNS LOOP
SHREVEPORT, LA 71105
Caddo Parish (318) 798-4573
HIGHLAND CLINIC, A PROF MED CORP
Clinic/Center (Multi-Specialty)
1455 E BERT KOUNS LOOP
SHREVEPORT, LA 71105
Caddo Parish (318) 798-4500
PAULA NICOLE SPIKES PA-C
Physician Assistant
1455 E BERT KOUNS LOOP, #109
SHREVEPORT, LA 71105
Caddo Parish (318) 798-4458
JUDD H CHIDLOW MD
Otolaryngology
1455 E BERT KOUNS LOOP
SHREVEPORT, LA 71105
Caddo Parish (318) 798-4569
DR. DONNA J RUSHING MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1455 E BERT KOUNS LOOP
SHREVEPORT, LA 71105
Caddo Parish (318) 798-4488
DAVID COOKSEY MD
Dermatology
1455 E BERT KOUNS LOOP
SHREVEPORT, LA 71105
Caddo Parish (318) 798-4677

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 Jo Goodeaux Broussard's NPI number?

The NPI number for Jo Goodeaux Broussard is 1578890190. It was assigned to this individual provider in the NPPES registry on November 4, 2009.

Where is Jo Goodeaux Broussard located?

Jo Goodeaux Broussard practices at 1455 E Bert Kouns Loop Suite #210, Shreveport, LA 71105. The listed phone number is (318) 798-4623.

What is Jo Goodeaux Broussard's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Jo Goodeaux Broussard was last updated on October 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.