Active NPI
Crystal Anne Brooks, MSCCCSLP
- Speech-Language Pathologist
- Phoenix, AZ
National Provider Identifier
1124289988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP4376
- Practice address
- 4600 E Shea Blvd
Suite 101
Phoenix, AZ 85028-6024 - Phone
- (602) 368-8601
- NPI assigned
- Jun 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP4376 | AZ | Primary |
Addresses
Primary practice location
4600 E Shea Blvd
Suite 101
Phoenix, AZ 85028-6024
Mailing address
5826 E Hartford Ave
Scottsdale, AZ 85254
Phone (602) 334-1175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 896798 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP4376 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248998400000",
"number": "1124289988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5826 E HARTFORD AVE",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85254",
"telephone_number": "602-334-1175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 E SHEA BLVD",
"address_2": "SUITE 101",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850286024",
"telephone_number": "602-368-8601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "CRYSTAL",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "MSCCCSLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-24",
"last_updated": "2009-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP4376",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "896798",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.