Active NPI
Phyllis Denise Brooks
- Speech-Language Pathologist
- Matthews, NC
National Provider Identifier
1245613314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 11178
- Practice address
- 1017 Murandy LN
Matthews, NC 28104-8052 - Phone
- (704) 451-5633
- Fax
- (844) 294-3070
- NPI assigned
- Jul 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 11178 | NC | Primary |
Addresses
Primary practice location
1017 Murandy LN
Matthews, NC 28104-8052
Mailing address
1017 Murandy LN
Matthews, NC 28104-8052
Phone (704) 451-5633
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 |
|---|---|---|---|
| 11178 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436227200000",
"number": "1245613314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1017 MURANDY LN",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281048052",
"telephone_number": "704-451-5633",
"fax_number": "844-294-3070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 MURANDY LN",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281048052",
"telephone_number": "704-451-5633",
"fax_number": "844-294-3070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "PHYLLIS",
"middle_name": "DENISE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-07",
"last_updated": "2015-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "11178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matthews, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.