Copper Mountain Speech Therapy LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

COPPER MOUNTAIN SPEECH THERAPY LLC

Practice address

1218 W South Jordan Pkwy Ste C
South Jordan, UT 84095-5517

Phone

(385) 246-2684

NPI assigned

Jul 31, 2024

Last updated

Jul 31, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebecca A. Bruso, CCC-SLPNPI 1720770019

Title

Owner, Clinician

Phone

(385) 246-2684

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rebecca Bruso, CCC-SLP

  • Speech-Language Pathologist
  • San Antonio, TX
  • NPI 1720770019
  NPD Authorized official

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1255160974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 W SOUTH JORDAN PKWY STE C",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955517",
            "telephone_number": "385-246-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 W SOUTH JORDAN PKWY STE C",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955517",
            "telephone_number": "385-246-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER MOUNTAIN SPEECH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "BRUSO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER, CLINICIAN",
        "authorized_official_telephone_number": "385-246-2684",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Speech-Language Pathologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.