Brooke Blaisdell

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ11580 Issued in FL

Practice address

5647 Gulf Dr
New Port Richey, FL 34652-4019

Phone

(813) 435-3355

NPI assigned

Dec 20, 2021

Last updated

Sep 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bayside Speech Therapy, Inc.

  dba Bayside Therapy Specialists

  • Clinic/Center
  • New Port Richey, FL
  • NPI 1578954962

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1255091195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 N LOIS AVE APT 1327",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072559",
            "telephone_number": "727-452-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5647 GULF DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524019",
            "telephone_number": "813-435-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "BROOKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ11580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Bird, M.A., CCC-SLP
• Birth God's Way, Inc.
• Molly Bishop
• Troy Lang Bishop
• Tara Paige Bjorkman, LMHC
• Michael Scott Blakeslee, PA-C
• Staci Blakeslee
• Allisha Louise Blanco, D.C.
• Callie Lynn Blanco, APRN
• Haley M Bland, LCSW

• Speech-Language Pathologist in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.