Sarah Grace Brennan, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Ankeny, IA
NPI 1376304394 · NPPES record last updated Feb 8, 2024
Key facts
- NPI
- 1376304394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 123590 (IA)
- Practice address
- 2455 SW State St Ste 45&6
Ankeny, IA 50023-1277 - Phone
- (515) 963-4528
- NPI assigned
- Jan 17, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240319002339 | IA | Practitioner - Qualified Speech Language Pathologist | 6406293059 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123590 | IA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physiotherapy Associates Inc | Current |
Accepting new patients | |
| Physiotherapy Associates Inc | Current | Accepting new patients | |
| Central Iowa Physio LLC | Current |
Accepting new patients | |
| Central Iowa Physio, LLC | Current |
Accepting new patients | |
| Physiotherapy Associates, Inc. | Current |
Accepting new patients | |
| Central Iowa Physio LLC | Current | Accepting new patients |
Locations
2455 SW State St
Ste 4
Ankeny, IA 50023
Phone (515) 963-4528
5900 NW 86th St
Ste 200
Johnston, IA 50131
Phone (515) 278-8151
1307 S Broadway St
Toledo, IA 52342
Phone (641) 484-5253
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 123590 | IA | Yes |
Addresses
Primary practice location
2455 SW State St Ste 45&6
Ankeny, IA 50023-1277
Mailing address
2455 SW State St Ste 45&6
Ankeny, IA 50023-1277
Phone (515) 963-4528
Other names
- Sarah Grace Plock
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All providers in Ankeny, IA · Speech-Language Pathologist in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.