Nicole Brogan

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

115 W 181 St Terr
Belton, MO 60412

Phone

(562) 454-6473

NPI assigned

Sep 7, 2021

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 10, 2025.

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1104595925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 GARDENDALE ST STE 104B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293142",
            "telephone_number": "210-582-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 181 ST TERR",
            "city": "BELTON",
            "state": "MO",
            "postal_code": "60412",
            "telephone_number": "562-454-6473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-07-10",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "42040",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bone & Joint Specialists Physician Group, LLC
• Bone&Joint Specialist P.C.
• Erica Renee Bourbon, ANP-BC
• Bracken Homes
• Douglas L Bradley, MD
• Elaine M. Broockerd, SPEECH PATHOLOGIST
• Christopher Brown
• Nicole Brown
• Kayla Burk
• Ruth Butler, RN

• All providers in Belton, MO
• Behavior Technician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.