Individual provider Active NPI

Vicki Ann Brumberg, CCC-SLP

  • Speech-Language Pathologist
  • Henderson, NV
National Provider Identifier
1295230506
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-2006 Issued in NV
Practice address
2441 W Horizon Ridge Pkwy
Henderson, NV 89052-5788
Phone
(702) 612-4569
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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 SP-2006 NV Primary

Addresses

Primary practice location

2441 W Horizon Ridge Pkwy
Henderson, NV 89052-5788

Mailing address

870 Armada PL
Boulder City, NV 89005-2375

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

LicenseStateTypeSpecialty
SP-2006NVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1295230506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 ARMADA PL",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890052375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525788",
            "telephone_number": "702-612-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMBERG",
        "first_name": "VICKI",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP-2006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.