Brenna Merry Roberts, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

027954 Issued in NY

Practice address

1000 Elmwood Ave Ste 100
Rochester, NY 14620-3093

Phone

(315) 532-9676

NPI assigned

Aug 13, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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.

• The Network for Children'S Speech, Occupational and Physical Therapy

  • Early Intervention Provider Agency
  • Syracuse, NY
  • NPI 1619113255
  NPD (past)

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1003395898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 BALSAM ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146101417",
            "telephone_number": "315-532-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ELMWOOD AVE STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203093",
            "telephone_number": "315-532-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRENNA",
        "middle_name": "MERRY",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "027954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert P. Weis DDS PC
• Segundo Sergio Robert-Ibarra, M.D.
• Adria Lara Roberti Miller, DO
• Annie Roberts
• Azellee Nariah Roberts
• Charles Roberts, OTR/L
• Debra E Roberts, MD, PHD
• Ellen Swain Roberts, MA, CCC/SLP
• Emma K Roberts, OT
• Harold John Roberts, OD

• Speech-Language Pathologist in Rochester, NY
• Providers in Rochester, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.