Brave Roots Speech Therapy PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BRAVE ROOTS SPEECH THERAPY PLLC

Practice address

4405 Live Oak TRL
Durham, NC 27705-9606

Phone

(919) 907-0849

NPI assigned

May 24, 2021

Organization subpart

No

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

Authorized official

Name

Jacquelyn VorndranNPI 1427572304

Title

SLP

Phone

(919) 907-0849

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brave Roots Speech Therapy Doing business as

Electronic endpoints 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacquelyn Vorndran

  • Speech-Language Pathologist
  • Durham, NC
  • NPI 1427572304
  NPD Authorized official
• Amelia Caroline Kramer, MA-CCC-SLP

  • Speech-Language Pathologist
  • Durham, NC
  • NPI 1427894799
  NPD

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1003481813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 LIVE OAK TRL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277059606",
            "telephone_number": "919-907-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 LIVE OAK TRL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277059606",
            "telephone_number": "919-907-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVE ROOTS SPEECH THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "VORNDRAN",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "SLP",
        "authorized_official_telephone_number": "919-907-0849"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427572304",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "braverootsnc.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4405 Live Oak Trl",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277059606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Brave Roots Speech Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ann Carol Braswell
• Erica Braswell, LPN
• Robin Michelle Braswell
• Siyonka Petrise Braswell
• Danielle Marie Brathwaite, MD
• Amy Braverman
• Casey Brawn, MS RD LDN
• Loretta Elaine Braxton, PH.D.
• Shelly Bray, LCSW
• Nicholas Ford Brazeau

• Speech-Language Pathologist in Durham, NC
• Providers in Durham, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.