Individual provider Active NPI

Brooke Cuff Burguillos

  • Speech-Language Pathologist
  • Villa Rica, GA
National Provider Identifier
1376266569
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP011876 Issued in GA
Practice address
1046 Monticello Dr
Villa Rica, GA 30180-7801
Phone
(770) 212-0750
NPI assigned
Sep 22, 2022
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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 SLP011876 GA Primary

Addresses

Primary practice location

1046 Monticello Dr
Villa Rica, GA 30180-7801

Mailing address

1046 Monticello Dr
Villa Rica, GA 30180-7801
Phone (770) 212-0750

Other practice location 1

619 Newnan St
Carrollton, GA 30117-3428
Phone (770) 212-0750

Other identifiers 1

IdentifierTypeStateIssuer
15695481OtherCAQH

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL AbleRehab
CONNECT URL LittleCommunicators

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
SLP011876GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Communicators Speech-Language Pathologist CurrentSince Sep 23, 2024 Accepting new patients
Professional Rehabilitation Associates, LLC PastSince Sep 1, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1376266569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 MONTICELLO DR",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807801",
            "telephone_number": "770-212-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 MONTICELLO DR",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807801",
            "telephone_number": "770-212-0750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 Newnan St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301173428",
            "country_code": "US",
            "telephone_number": "770-212-0750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGUILLOS",
        "first_name": "BROOKE",
        "middle_name": "CUFF",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP011876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15695481",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "AbleRehab",
            "affiliation": "N",
            "endpointDescription": "Workplace",
            "address_1": "2000 Mirror Lake Blvd Ste T",
            "city": "Villa Rica",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301802126",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "LittleCommunicators",
            "affiliation": "N",
            "endpointDescription": "Workplace",
            "address_1": "1046 Monticello Dr",
            "city": "Villa Rica",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301807801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.