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Deactivated NPI 1992844476 Deactivated / Inactive NPI Male Practitioner

Dr. John King Broussard , EdD

Psychologist • Bedford, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Broussard has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 05, 2007
NPI Deactivation Date September 13, 2023
Total Practice Duration ~16 Years of Practice (2007 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. John Broussard, EdD was a registered Psychologist practicing in Bedford, TX. Throughout an active medical career spanning 16 years, Dr. Broussard provided care at the practice location at 1600 AIRPORT FWY until profile deactivation on 2023-09-13.

Historical Medicare Part B clinical services included psychotherapy. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1600 Airport Fwy
Suite 322

Bedford, TX 760226850

Telephone 8175718463
Fax 8175712280
Associated Practice Facility / Clinic
🏢 Ft. Worth Home Care Inc Facility NPI 1629499900

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Bedford, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
3 Specialists

Practicing in Bedford, TX (2266 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
1.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90837 Psychotherapy, 60 minutes
104 11 $100.00 $98.41

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License TX 22828

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dwight Morgan , MA, LPC

Counselor - Professional

NPI 1205845450

Master of Arts, Licensed Professional Counselor

Dr. Linda Willoughby , PHD LPC

Counselor - Mental Health

NPI 1376606301

PHDLPC

Debra Hilliard-Jones , RD, LD

Dietitian, Registered

NPI 1699914796

Registered Dietitian, Licensed Dietitian

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 13, 2023

Record deactivated on September 13, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1600 AIRPORT FWY, SUITE 322, BEDFORD, TX 760226850 (Tel: 8175718463)

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Updated Business Mailing Address July 08, 2007

Registered at 1600 AIRPORT FWY, SUITE 322, BEDFORD, TX 760226850 (Tel: 8175718463)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN BROUSSARD, ED.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #22828 in TX)

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Initial NPI Registration & Enumeration February 05, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992844476
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 05, 2007
Last Update: July 08, 2007
Deactivation Date: September 13, 2023

Mailing Address

1600 Airport Fwy, Suite 322

Bedford, TX 760226850

Phone: 8175718463

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.