Individual provider Active NPI

Brianna Hackett, MS CCC-SLP

  • Speech-Language Pathologist
  • Raleigh, NC
National Provider Identifier
1275293367
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2111081 Issued in NC
Practice address
2722 Hidden Waters Circle
Raleigh, NC 27614
Phone
(919) 465-4424
NPI assigned
Dec 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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 2111081 NC Primary

Addresses

Primary practice location

2722 Hidden Waters Circle
Raleigh, NC 27614

Mailing address

6310 Terra Verde Dr Unit 163
Raleigh, NC 27609-5395
Phone (518) 335-4596

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
2111081NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lolly Therapeutics, LLC Speech-Language Pathologist PastSince Jan 2, 2022 Accepting new patients
Venture Rehabilitation Group Speech-Language Pathologist Past Accepting new patients
KM Pediatric Therapy, Inc. Speech-Language Pathologist PastSince Jan 2, 2022 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1275293367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 TERRA VERDE DR UNIT 163",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095395",
            "telephone_number": "518-335-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 HIDDEN WATERS CIRCLE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27614",
            "telephone_number": "919-465-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "BRIANNA",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "2111081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.