Big Blue Star LLC
NPI 1396072344ActiveOrganization· Dietitian, Registered· Edmond, OK
Dietitian, Registered in Edmond, Oklahoma, registered in NPPES in November 2009. The authorized official on file is Toby Daniel Broussard, MD, Co Owner.
Overview
| NPI | 1396072344 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 12, 2009 |
| Last updated in NPPES | Dec 17, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | — | — |
| Specialist | 174400000X | — | — |
| Surgery | 208600000X | — | — |
| Clinical Medical Laboratory | 291U00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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