Individual provider Active NPI

Brooke L Greene, SLP

  • Speech-Language Pathologist
  • Raleigh, NC
National Provider Identifier
1104057520
Registry record updated Aug 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8631 Issued in NC
Practice address
3013 Idlewood Village Dr
Raleigh, NC 27610-5966
Phone
(910) 297-2624
NPI assigned
Aug 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8631 NC Primary

Addresses

Primary practice location

3013 Idlewood Village Dr
Raleigh, NC 27610-5966

Mailing address

3013 Idlewood Village Dr
Raleigh, NC 27610-5966
Phone (910) 297-2624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325004056 NC Practitioner - Qualified Speech Language Pathologist 6800233909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

145 Dairy Rd
Clayton, NC 27520-4965
Phone (984) 232-7752

200 Kellie Dr
Smithfield, NC 27577-6500
Phone (984) 222-6279

3150 Burke Mill Rd
RM 200
Winston Salem, NC 27103-6431
Phone (336) 397-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8631NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Jan 6, 2024 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Jan 6, 2024 Accepting new patients

Locations

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1104057520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3013 IDLEWOOD VILLAGE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276105966",
            "telephone_number": "910-297-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3013 IDLEWOOD VILLAGE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276105966",
            "telephone_number": "910-297-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "BROOKE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-03",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "8631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.