Active NPI
Nicole Marie Brattlie
- Speech-Language Pathologist
- Mint Hill, NC
National Provider Identifier
1255650602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8196
- Practice address
- 6924 Evans Rd
Mint Hill, NC 28227-4424 - Phone
- (716) 864-3637
- NPI assigned
- May 25, 2010
- 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 | 8196 | NC | Primary |
Addresses
Primary practice location
6924 Evans Rd
Mint Hill, NC 28227-4424
Mailing address
6924 Evans Rd
Mint Hill, NC 28227-4424
Phone (716) 864-3637
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 |
|---|---|---|---|
| 8196 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274745600000",
"number": "1255650602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6924 EVANS RD",
"city": "MINT HILL",
"state": "NC",
"postal_code": "282274424",
"telephone_number": "716-864-3637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6924 EVANS RD",
"city": "MINT HILL",
"state": "NC",
"postal_code": "282274424",
"telephone_number": "716-864-3637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRATTLIE",
"first_name": "NICOLE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-25",
"last_updated": "2010-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "8196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mint Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.