Brandi Clary, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2016017138 Issued in MO

Practice address

3545 S National Ave
Springfield, MO 65807-7310

Phone

(417) 269-4601

NPI assigned

Jul 30, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Brandi Hogan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lester E Cox Medical Centers

  • Family Medicine Physician
  • Willow Springs, MO
  • NPI 1417122326
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1003394362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-269-5712",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077310",
            "telephone_number": "417-269-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARY",
        "first_name": "BRANDI",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2016017138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDI",
            "last_name": "HOGAN",
            "credential": "MS CCC SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Riki Lee Clark, PMHNP
• Ryleigh Clark, RD, LD
• Clarke Surgical Center, L.L.C.
• Lindsey Clarke
• Michael S Clarke, M.D.
• Dana L. Clawson, CRNA
• Carl D. Claxton, D.O.
• Clay Therapy LLC
• Dick Clay, HIS
• Robin A. Clay, H.I.S.

• All providers in Springfield, MO
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.