Individual provider Active NPI

Brooke Hammond Peccia, MS, CCC-SLP

  • Speech-Language Pathologist
  • Johnson City, TN
National Provider Identifier
1235308156
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 0000002635 Issued in TN
Practice address
208 Sunset Dr
Suite 367
Johnson City, TN 37604-2517
Phone
(423) 282-1700
Fax
(423) 282-9319
NPI assigned
Feb 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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 SP 0000002635 TN Primary

Addresses

Primary practice location

208 Sunset Dr
Suite 367
Johnson City, TN 37604-2517

Mailing address

208 Sunset Dr
Suite 367
Johnson City, TN 37604-2517
Phone (423) 282-1700

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP 0000002635TNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1235308156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SUNSET DR",
            "address_2": "SUITE 367",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042517",
            "telephone_number": "423-282-1700",
            "fax_number": "423-282-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 SUNSET DR",
            "address_2": "SUITE 367",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042517",
            "telephone_number": "423-282-1700",
            "fax_number": "423-282-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECCIA",
        "first_name": "BROOKE",
        "middle_name": "HAMMOND",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SP 0000002635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; 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.