Active NPI
Brooke Chesnut, M.S. CF-SLP
- Speech-Language Pathologist
- Kennesaw, GA
National Provider Identifier
1346714672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- PCET002798
- Practice address
- 3105 Creekside Village Dr NW Ste 602-604
Kennesaw, GA 30144-2394 - Phone
- (770) 974-2424
- NPI assigned
- Jan 21, 2019
- 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 | PCET002798 | GA | Primary |
Addresses
Primary practice location
3105 Creekside Village Dr NW Ste 602-604
Kennesaw, GA 30144-2394
Mailing address
3105 Creekside Village Dr NW Ste 603604
Kennesaw, GA 30144-2394
Phone (770) 974-2424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PCET002798 | Other | GA | GEORGIA STATE LICENSURE |
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 |
|---|---|---|---|
| PCET002798 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548028800000",
"number": "1346714672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3105 CREEKSIDE VILLAGE DR NW STE 603604",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301442394",
"telephone_number": "770-974-2424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3105 CREEKSIDE VILLAGE DR NW STE 602-604",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301442394",
"telephone_number": "770-974-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHESNUT",
"first_name": "BROOKE",
"credential": "M.S. CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-21",
"last_updated": "2019-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "PCET002798",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA STATE LICENSURE",
"identifier": "PCET002798",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.