Individual provider Active NPI

Brittany McDonald, CCC-SLP

  • Speech-Language Pathologist
  • Antioch, TN
National Provider Identifier
1346875283
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6838 Issued in TN
Practice address
889 Bell Rd
Antioch, TN 37013-3101
Phone
(812) 617-0492
NPI assigned
Mar 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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 6838 TN Primary

Addresses

Primary practice location

889 Bell Rd
Antioch, TN 37013-3101

Mailing address

905 Gibson Dr
Madison, TN 37115-4541

Other names 1

  • Brittany Archer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210226002171 TN Practitioner - Qualified Speech Language Pathologist 0345655205 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6838TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
High Pointe Rehab LLC CurrentSince Feb 25, 2021 Accepting new patients

Locations

298 Warfield Blvd
Apt C
Clarksville, TN 37043
Phone (931) 906-0440

2319 Rudolphtown Rd
Clarksville, TN 37043
Phone (931) 920-4333

461 Pond Apple Rd
Clarksville, TN 37043
Phone (931) 920-4333

Organizations & group practices 1

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": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1346875283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 GIBSON DR",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 BELL RD",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133101",
            "telephone_number": "812-617-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "BRITTANY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "6838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "ARCHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Antioch, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.