Brodie Robert Long, OTD, OTR/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

301 Edelweiss Dr Ste 7
Bozeman, MT 59718-3931

Phone

(406) 219-2114

Fax

(406) 219-2145

NPI assigned

Nov 22, 2024

Last updated

Nov 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• Foundation Therapy Services Inc

  • Speech-Language Pathologist
  • Bozeman, MT
  • NPI 1104335942
  NPD

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1336964469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 SAXON WAY APT D",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186536",
            "telephone_number": "406-439-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 EDELWEISS DR STE 7",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183931",
            "telephone_number": "406-219-2114",
            "fax_number": "406-219-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "BRODIE",
        "middle_name": "ROBERT",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MT",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teema Boies Loeffelholz, LCPC
• Lone Peak Physical Therapy Inc
• Lone Peak Physical Therapy, Inc
• Lone Peak Physical Therapy, Inc.
• Alysan N Long, D.P.T.
• Carolyn S Long, MCD CCC/SLP
• Shaina Helene Long, D.O.
• Sara R Longobardi, PA-C
• Clarissa M Lorance, NP
• David Keith Lorance Jr., M.D.

• Speech-Language Pathologist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Speech-Language Pathologist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.