Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Kanon Broussard

Individual provider Physical Therapist · NPI 1639521172

Kanon Broussard is registered under Physical Therapist in Private Practice in Huntersville, North Carolina. Qualified in 2016, 10 years ago. Practices with Synergy Care Southeast LLC, a 199-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
10
Licensed in
LA
In the registry since
2016
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Practice location Address checks out

16405 Northcross Dr Ste G-2
Huntersville, NC 28078-5091 Not confirmed with CMS for 10 years — call before visiting
Phone: (866) 214-9644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 09393 (LA)

Record details

NPI number1639521172
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 8, 2016
Last updated in NPPESJuly 8, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Synergy Care Southeast Llc — 199 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients12
Services billed 49 a service is one billed item, such as a visit, a test or a procedure
Average patient age86

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Synergy Care Southeast LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 199 clinicians in the practice; 12 are shown here.

Other providers in Huntersville