Active NPI
Brianna Hackett, MS CCC-SLP
- Speech-Language Pathologist
- Raleigh, NC
National Provider Identifier
1275293367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2111081
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2111081 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lolly Therapeutics, LLC | Speech-Language Pathologist | Past | Accepting new patients |
| Venture Rehabilitation Group | Speech-Language Pathologist | Past | Accepting new patients |
| KM Pediatric Therapy, Inc. | Speech-Language Pathologist | Past | 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.
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Speech-Language Pathologist
-
- Speech-Language Pathologist
- Greenville, NC
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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.