Tracy Joy Brynelsen, TSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8982 Issued in MN

Practice address

3030 92ND Ave NE
Blaine, MN 55449-5624

Phone

(651) 269-5055

NPI assigned

Sep 1, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1013224773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 92ND AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 92ND AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495624",
            "telephone_number": "651-269-5055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Havasupai Blvd",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864033122",
            "country_code": "US",
            "telephone_number": "928-505-6938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYNELSEN",
        "first_name": "TRACY",
        "middle_name": "JOY",
        "credential": "TSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP6883",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Brogger, MA LADC
• Brookdale Senior Living Communities Inc (Sterling House of Blaine)
• Andrew William Brown, D.C.
• Carolyn L Brown
• Deborah Ann Brown, APNP
• Kyra Bryz-Gornia, RN
• Dillon Thomas Buchanan
• Josie Bungert, RN
• Erin M Burton, PA
• Erin Marie Burton, PHARMD

• Speech-Language Pathologist in Blaine, MN
• Providers in Blaine, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.